EURORAD ESR

Case 9237

Renal and pancreatic involvement in polyarteritis nodosa: diagnosis with MDCT angiography

Author(s)
Tonolini M, Columpsi D*, Scannella E*, Badini M* Montano Nicola*.
Department of Radiology and *Internal Medicine II, “Luigi Sacco" University Hospital – Milan (Italy)
 
Patient
male, 42 year(s)
 
 
  • Figure 1
    Abdominal MDCT
     

    Preliminary unenhanced acquisition show normal-sized kidneys, enlargement and inhomogeneity of the distal pancreas with peripancreatic oedema.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;

    Arterial-phase CT images (b, c) show nonenhancing necrotic portion of the pancreatic tail; bilateral kidney involvement with multiple peripheral wedge-shaped hypovascular areas consistent with cortical infarcts.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;

    Arterial-phase CT images (b, c) show nonenhancing necrotic portion of the pancreatic tail; bilateral kidney involvement with multiple peripheral wedge-shaped hypovascular areas consistent with cortical infarcts.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;

    Kidney and pancreatic perfusion abnormalities are still appreciable in the excretory phase acquisition (d, e).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;

    Kidney and pancreatic perfusion abnormalities are still appreciable in the excretory phase acquisition (d, e).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 2
    MDCT angiographic reformations
     

    Main renal arteries have normal caliber, whereas intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms.

     
    Area of Interest: Abdomen; Imaging Technique: CT-Angiography; Special Focus: Aneurysms;

    Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with...

     
    Area of Interest: Abdomen; Imaging Technique: CT-Angiography; Special Focus: Aneurysms;

    Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with...

     
    Area of Interest: Abdomen; Imaging Technique: CT-Angiography; Special Focus: Aneurysms;

    Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Special Focus: Aneurysms;
     
     
Preliminary unenhanced acquisition show normal-sized kidneys, enlargement and inhomogeneity of the distal pancreas with peripancreatic oedema.
 
Arterial-phase CT images (b, c) show nonenhancing necrotic portion of the pancreatic tail; bilateral kidney involvement with multiple peripheral wedge-shaped hypovascular areas consistent with cortical infarcts.
 
Arterial-phase CT images (b, c) show nonenhancing necrotic portion of the pancreatic tail; bilateral kidney involvement with multiple peripheral wedge-shaped hypovascular areas consistent with cortical infarcts.
 
Kidney and pancreatic perfusion abnormalities are still appreciable in the excretory phase acquisition (d, e).
 
Kidney and pancreatic perfusion abnormalities are still appreciable in the excretory phase acquisition (d, e).
 
Main renal arteries have normal caliber, whereas intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms.
 
Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with discrete caliber abnormalities.
 
Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with discrete caliber abnormalities.
 
Intrarenal vessels bilaterally show diffuse irregularities with constrictions and focal dilatations consistent with vasculitis and micro-aneurysms. Gastroduodenal (b) and superior mesenteric arteries (c, d) with discrete caliber abnormalities.
 
 
 
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