Manuel A. Madayag

Angiographie Patterns in Renal Oncocytomas1

Renal oncocytomas are benign tumors arising from proximal tubular epithelial cells. They appear radiographically as solid masses which are vascular on angiography. Angiograms of 13 cases of renal oncocytomas were reviewed, as well as those of 155 renal-cell carcinomas. The classic angiographic findings for the oncocytoma include a spoke-wheel pattern, a homogeneous nephrogram, and a sharp, smooth rim. The finding of a homogenous blush and/or a spoke-wheel pattern greatly increases the possibility of an oncocytoma, though a renal-cell carcinoma may have any or all of the classical findings described for an oncocytoma.

Transfemoral Catheter Embolization of Cerebral and Posterior Fossa Arteriovenous Malformations

Abstract The transfemoral percutaneous catheterization technique for embolization of intracranial arteriovenous malformations is described, and its advantages over arteriotomy discussed. The use of preoperative and postoperative radionuclide flow studies as well as of angiography is suggested. The first report is given of embolization of the intra-axial blood supply of a posterior fossa arteriovenous malformation.

Involvement of the Inferior Vena Cava in Patients with Renal Cell Carcinoma

Inferior vena cavography plays an important role in the staging of renal cell carcinoma. The renal angiograms and inferior vena cavograms in a series of patients with renal cell carcinoma were reviewed to determine which patients require cavography. Our findings show that renal angiography is of great value in suggesting tumor involvement of the renal vein or vena cava, and that the decision to do cavography can be made from the angiographic findings. In the series of 172 patients with renal carcinoma, 15 or 9% had inferior vena cava involvement.

The Pear-Shaped Bladder

The tear-drop or pear-shaped bladder was originally described in cases of pelvic hematoma. It may also be seen, however, with a variety of other entities, including pelvic lipomatosis, inferior vena cava occlusion, lymphocysts, and enlarged pelvic lymph nodes. Pertinent radiographic findings of these conditions are reviewed.

Renal and Suprarenal Pseudotumors Caused by Variations of the Spleen

Abstract Variations in the contour and position of the spleen simulated renal or suprarenal masses on routine radiographic studies in 5 patients. Angiography was able to determine the true etiology of the apparent masses in 4 (assisted by isotopes in one case). Localized flattening of the upper pole of the kidney, usually thought to indicate adrenal disease, was seen in 3. Splenic variations included a lumpy spleen, a transverse spleen with a prominent superior pole, a rotated and ptotic spleen, a depressed spleen, and an accessory spleen.

Hemangiomas of the liver in patients with renal cell carcinoma.

Five patients with renal cell carcinoma were noted at angiography to have vascular hepatic lesions which resembled metastatic renal cell carcinoma but which proved to be benign hepatic hemangiomas. The angiographic differentiation between small hemangiomas and metastatic vascular neoplasms of the liver can be difficult; angiographic characteristics may not be definitive. Surgery to remove the renal tumor should not be deferred solely on the basis of vascular hepatic lesions found at angiography.

Origin of the inferior mesenteric artery from the renal artery in fused crossed renal ectopia

During angiography of a mass in an ectopic kidney (crossed fused renal ectopia), it was noted that the inferior mesenteric artery arose entirely from the renal artery supplying the ectopic kidney. To our knowledge, the angiographic demonstration of this unusual arterial anomaly has not been previously reported.

Angiographic demonstration of bleeding site following late rare complication of aorto-coronary by-pass

The intravascular injection of contrast may demonstrate the site of bleeding more successfully than conventional radiographic methods. This technique has been applied to lesions involving various sites. The application of angiography to demonstrate a bleeding site following a late unsuspected complication (removal of epicardial pacemaker) after aorto-coronary saphenous vein by-pass grafting has to our knowledge, not yet been reported in the literature, although uneventful perforation of a coronary artery during coronary catheterization has been observed (Morettin and Wallace, 1970).

“Cobblestone” renal pelvis Radiographic finding in acute renal vein thrombosis

Abstract The cobblestoned appearance of the infundibuli, pelvis, and ureter are diagnostic retrograde urographic findings in acute renal vein thrombosis. This radiographic change is believed to be due to acute bullous edema.

A modified technique of inferior vena cavography.

Abstract Optimum opacification of the inferior vena cava was obtained with a modified technique of cavography using a hook catheter. This method is simple and safe and eliminates possible complications associated with current techniques.