Toshiyuki Nagashima

CT demonstration of portal vein aneurysm.

We report a case of portal vein aneurysm showing characteristic enhancement on dynamic CT.

Right double inferior vena cava : Report of 5 cases and literature review

Objective: To describe the computed tomography appearance, embryology, and clinical implications of right double inferior vena cava (IVC). Methods: Computed tomography imaging findings were retrospectively reviewed in our 5 patients and in 2 cases reported in the literature with right double IVC. The relationship of the 2 postrenal IVCs, their diameter, level of confluence of the 2 IVCs, course of the left common iliac vein, draining site of the right gonadal vein, and the presence of retrocaval ureter were evaluated. Results: In all cases, the relationship of 2 IVCs was ventral-dorsal, and the left common iliac vein passed ventral to the aortic bifurcation or the right common iliac artery. The relationship of the diameters and level of confluence of the 2 IVCs were variable. The right gonadal vein drained into the ventral vessel in 4 cases and into the IVC between the renal venous confluence and the confluence of the 2 vessels in 1 case. In all cases, the retrocaval ureter was not identified. Conclusions: Characteristic computed tomography findings of right double IVC were a ventral-dorsal relationship between the 2 vessels and the unusual course of the left common iliac vein. Embryologically, the ventral vessel originates from the right subcardinal vein, whereas the dorsal vessel originates from the right supracardinal vein. Although this anomaly is extremely rare, radiologists should recognize it.

The posterior inferior cerebellar artery arising from the extracranial segment of the internal carotid artery via the hypoglossal canal without an interposed segment of the basilar artery:A persistent primitive hypoglossal artery variant

The authors present a rare case of a persistent primitive hypoglossal artery (PHA) variant ending in the posterior inferior cerebellar artery (PICA) without an interposed segment of the basilar artery and describe briefly the possible embryogenesis of this anomaly.

Balloon-occluded retrograde transvenous obliteration for gastric varices with plural draining veins: effectiveness of coil embolization for collaterals.

B-RTO in gastric varices was first described in 1991, and has become a major treatment of large gastric fundal varices with a GRS. However, difficult cases have been reported, e.g. in our own experiences in gastric varices with plural draining veins. We have demonstrated that treatDear Sir, A 60-year-old woman was admitted to our hospital for the treatment of gastric varices which had gradually grown larger. Because a computed tomography showed a gastrorenal shunt (GRS), we carried out balloon-occluded retrograde transvenous obliteration (B-RTO) for her gastric varices. An occlusive balloon catheter was inserted into the GRS through the left renal vein and venography was performed. The gastric varices were partly opacified because of high blood flow to another GRS and to the inferior phrenic vein. First, the super selective insertion to another GRS was successful, and the coil embolization was performed. Second, a catheter was inserted via the inferior phrenic vein, and coil embolization was performed for the variceal drainage vein. After coil embolization, using 5 ml 5% ethanolamine oleate, the gastric varices were filled and a feeding vein was opacified ( fig. 1 ). At endoscopic examination 3 months after B-RTO, the patient’s gastric varices had disappeared. Published online: May 18, 2007