EURORAD ESR

Case 9421

Pulmonary embolism in heterotaxy syndrome

Author(s)
Hofmann AK
 
Patient
female, 64 year(s)
 
 
  • Figure 1
    Contrast-enhanced CT of thorax and abdomen (soft tissue window)
     

    Axial slice at the level of the azygos vein outlet into the superior vena cava shows dilatated azygos vein and left superior vena cava.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital; Dilatation;

    Axial slice at the level of pulmonary arteries demonstrates pulmonary embolism, ectasia of the aorta ascendens, dilatated azygos vein (anterior to the spine) and left superior vena cava (to the left of the pulmonary...

     
    Area of Interest: Anatomy; Arteries / Aorta; Pulmonary vessels; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital; Dilatation; Embolism / Thrombosis;

    Axial slice at the level of the insertion of the suprahepatic inferior vena cava into the right atrium.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;

    Axial slice at a lower level than the previous shows suprahepatic inferior vena cava (anterior to the aorta) and dilatated azygos vein (to the right of the aorta).

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital; Dilatation;

    Axial slice at the level of the hepatic venous confluence into the suprahepatic inferior vena cava.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;

    Axial slice at a lower level than the previous shows polysplenia, bridging liver, central gallbladder, absence of the intrahepatic inferior vena cava and dilatated azygos vein.

     
    Area of Interest: Abdomen; Anatomy; Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Axial slice at a lower level than the previous demonstrates intestinal malrotation with small intestine on the right side and colon on the left side of the abdominal cavity.

     
    Area of Interest: Abdomen; Anatomy; Gastrointestinal tract; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;
     
     
  • Figure 2
    Contrast-enhanced CT (MPR in coronal, sagittal and oblique planes)
     

    Coronal reformatted image shows left superior vena cava, suprahepatic inferior vena cava, bridging liver and intestinal malrotation with small intestine on the right side and colon on the left side of the abdominal...

     
    Area of Interest: Anatomy; Gastrointestinal tract; Liver; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Coronal reformatted image at the level of main stem bronchi demonstrates bilateral hyparterial bronchi.

     
    Area of Interest: Anatomy; Pulmonary vessels; Respiratory system; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Coronal reformatted image shows polysplenia and dilatated azygos vein, in consequence of inferior vena cava interruption with azygos continuation.

     
    Area of Interest: Anatomy; Spleen; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Coronal oblique reformatted image demonstrates interruption of the inferior vena cava (at the level of the kidney veins) and its continuation in the azygos vein.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Sagittal reformatted image demonstrates inferior vena cava (IVC) interruption with absence of the intrahepatic IVC segment and presence of suprahepatic IVC (from the hepatic venous confluence to the right atrium).

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Sagittal oblique reformatted image demonstrates inferior vena cava (IVC) interruption with azygos continuation of the infrahepatic IVC, absence of the intrahepatic IVC and presence of suprahepatic IVC.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Contrast agent-oral; Special Focus: Congenital;

    Coronal reformatted MIP image shows the hepatic venous confluence into the suprahepatic inferior vena cava (IVC). The intrahepatic IVC segment is absent.

     
    Area of Interest: Anatomy; Veins / Vena cava; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Congenital;
     
     
Axial slice at the level of the azygos vein outlet into the superior vena cava shows dilatated azygos vein and left superior vena cava.
 
Axial slice at the level of pulmonary arteries demonstrates pulmonary embolism, ectasia of the aorta ascendens, dilatated azygos vein (anterior to the spine) and left superior vena cava (to the left of the pulmonary trunk).
 
Axial slice at the level of the insertion of the suprahepatic inferior vena cava into the right atrium.
 
Axial slice at a lower level than the previous shows suprahepatic inferior vena cava (anterior to the aorta) and dilatated azygos vein (to the right of the aorta).
 
Axial slice at the level of the hepatic venous confluence into the suprahepatic inferior vena cava.
 
Axial slice at a lower level than the previous shows polysplenia, bridging liver, central gallbladder, absence of the intrahepatic inferior vena cava and dilatated azygos vein.
 
Axial slice at a lower level than the previous demonstrates intestinal malrotation with small intestine on the right side and colon on the left side of the abdominal cavity.
 
Coronal reformatted image shows left superior vena cava, suprahepatic inferior vena cava, bridging liver and intestinal malrotation with small intestine on the right side and colon on the left side of the abdominal cavity.
 
Coronal reformatted image at the level of main stem bronchi demonstrates bilateral hyparterial bronchi.
 
Coronal reformatted image shows polysplenia and dilatated azygos vein, in consequence of inferior vena cava interruption with azygos continuation.
 
Coronal oblique reformatted image demonstrates interruption of the inferior vena cava (at the level of the kidney veins) and its continuation in the azygos vein.
 
Sagittal reformatted image demonstrates inferior vena cava (IVC) interruption with absence of the intrahepatic IVC segment and presence of suprahepatic IVC (from the hepatic venous confluence to the right atrium).
 
Sagittal oblique reformatted image demonstrates inferior vena cava (IVC) interruption with azygos continuation of the infrahepatic IVC, absence of the intrahepatic IVC and presence of suprahepatic IVC.
 
Coronal reformatted MIP image shows the hepatic venous confluence into the suprahepatic inferior vena cava (IVC). The intrahepatic IVC segment is absent.
 
 
 
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