Frank A. Giargiana

Absence of Anatomic Arteriovenous Shunts in Paget's Disease of Bone

Abstract To determine whether anatomic shunting through arteriovenous (AV) anastomoses is responsible for the circulatory abnormalities associated with Pagets disease of bone, shunting of particles, 15 to 30 μ in diameter, was measured in nine patients. In addition, relative regional perfusion, radiographs and serum alkaline phosphatase were measured. Hemodynamic data were obtained in three of the patients. No AV shunting was found, despite the fact that blood flow to the involved bone was increased in every case and AV oxygen differences were decreased in some. We therefore conclude that hyperperfusion of diseased bone rather than AV shunting is responsible for the hyperkinetic circulation and decreased AV oxygen differences in patients with Pagets disease of bone.

CT findings in splenic hemangiomas in the Klippel-Trenaunay-Weber syndrome

The Klippel-Trenaunay-Weber syndrome consists of cutaneous port wine hemangiomas, superficial venous varicosities, and soft tissue and bony hypertrophy of an extremity. We describe three patients with this syndrome with hypodense lesions in the spleen which in one case became isodense after bolus contrast CT. In one case ultrasound found numerous echopenic and echogenic masses. These lesions are presumed to represent multiple hemangiomata.

A Preliminary Report on the Complementary Roles of Arteriography and Perfusion Scanning in Assessment of Peripheral Vascular Disease

The evaluation of peripheral vascular disease in man includes various clinical and radiographic procedures. Arteriography is useful in the detection of gross anatomical changes but does not provide information about muscle perfusion. 99mTc-labelled microspheres were utilized in 50 patients to evaluate extremity perfusion patterns and to provide a qualitative assessment of muscle perfusion. Correlative studies were carried out comparing perfusion scans with clinical history, arteriographic findings and surgical results.

Absence of arteriovenous shunting in peripheral arterial disease.

Previous studies suggest that arteriovenous shunts are present in peripheral arterial disease and account for early venous opacification seen during arteriography. To evaluate this hypothesis, thirty patients were studied by injecting 99mtechnetium-labeled microspheres intra-arterially following translumbar catheterizadon of the abdominal aorta. With this technique, if shunting is present, increased counts will be detectable while counting over the lungs. Repeat shunt determinations were made in 20 patients after injection of radiopaque contrast material, and in 10 patients during the period of reactive hyperemia following 5 minutes of arterial occlusion. Significant arteriovenous shunting was not present in any of the study groups.