EURORAD ESR

Case 15300

Aortoiliac Occlusive Disease – Asymptomatic Leriche Syndrome

Author(s)
Ana Sofia Linhares Moreira 1 ;
Rui Osório 2 ;
Yessica Costa 3

1 - Centro Hospitalar Universitário do Algarve, Faro Unit, Radiology Department ; Rua Penedo Leão 8000-386 Faro, Portugal
2 - Centro Hospitalar Universitário do Algarve, Faro Unit, Internal Medicine Department ; Rua Penedo Leão 8000-386 Faro, Portugal
3 - Centro Hospitalar Universitário de Coimbra, Radiology Department ; Coimbra
 
Patient
male, 55 year(s)
 
 
  • Figure 1
    Small right renal infarct

    Arterial axial abdominal CT. Slight hepatomegaly, no other relevant liver changes. Aorta and celiac trunk permeable. Peripheral hypodensity in the superior pole of the right kidney (arrow), possibly related to renal...

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 2
    Occluded aorta distally to right renal artery

    Arterial coronal abdominal CT. Superior segment of abdominal aorta and right renal artery are permeable. Atheromatous changes without opacification of aorta and its branches distally to the right renal artery origin...

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 3
    Occluded aorta with permeable SMA

    Arterial axial abdominal CT. Left kidney is small and does not enhance normally - renal infarction. Aorta is not opacified - occlusive thrombus (black arrow) - while superior mesentery artery (SMA) is permeable (white...

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 4
    Occluded common iliac arteries with collateral circulation

    Arterial axial pelvic CT. Common iliac arteries show atheromatous calcification without opacification (blue circles). Small arteries (white arrows) are opacified - collateral visceral pathway – as are the inferior...

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 5
    Occluded aorta with collateral circulation

    Coronal MIP. Superior third of aorta (AA), superior mesenteric artery (SMA) and right renal artery (RRA) are permeable. Infra-renal aorta, left renal, inferior mesenteric and iliac arteries are not opacified but...

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 6
    Occluded aorta with collateral circulation

    Coronal oblique MIP. Dilated inferior epigastric arteries (IEA) and internal thoracic arteries (ITA) in the anterior abdominal wall, form the Winslow pathway, a collateral systemic-systemic pathway.

     
    Area of Interest: Cardiovascular system; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Ischaemia / Infarction;
     
     
Arterial axial abdominal CT. Slight hepatomegaly, no other relevant liver changes. Aorta and celiac trunk permeable. Peripheral hypodensity in the superior pole of the right kidney (arrow), possibly related to renal infarct.
 
Arterial coronal abdominal CT. Superior segment of abdominal aorta and right renal artery are permeable. Atheromatous changes without opacification of aorta and its branches distally to the right renal artery origin – thrombosed segment.
 
Arterial axial abdominal CT. Left kidney is small and does not enhance normally - renal infarction. Aorta is not opacified - occlusive thrombus (black arrow) - while superior mesentery artery (SMA) is permeable (white arrow).
 
Arterial axial pelvic CT. Common iliac arteries show atheromatous calcification without opacification (blue circles). Small arteries (white arrows) are opacified - collateral visceral pathway – as are the inferior epigastric arteries (white circles) - Winslow pathway.
 
Coronal MIP. Superior third of aorta (AA), superior mesenteric artery (SMA) and right renal artery (RRA) are permeable. Infra-renal aorta, left renal, inferior mesenteric and iliac arteries are not opacified but thrombosed with atheromatous calcifications.
 
Coronal oblique MIP. Dilated inferior epigastric arteries (IEA) and internal thoracic arteries (ITA) in the anterior abdominal wall, form the Winslow pathway, a collateral systemic-systemic pathway.
 
 
 
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