Budd-Chiari syndrome: A rare association of Scimitar syndromeA 3-year-old asymptomatic girl was noted to have a heart murmur. Chest X-ray showed a curvilinear shadow along the right heart border (Fig. 1A) characteristic of the Scimitar sign. Echocardiography revealed a Scimitar vein (SV) draining the entire right lung to the inferior vena cava (IVC) which was stenosed at the junction with SV (Fig. 1B; arrow). CT angiography and hepatic venography revealed a 1.5 cm-long segment of stenosis in the IVC proximal to the insertion of the SV, resulting in outflow obstruction of short hepatic veins (HVs) with resultant intrahepatic veno-venous collaterals which coursed to the IVC above the level of stenosis (Fig. 2).
Simple cough presentation of a rare variant of a meandering left pulmonary veinA 17-year-old female presenting to respiratory clinic with 4 months history of mild cough. Her physical examination is unremarkable. A chest radiograph showed a left-sided peri-hilar high-density tubular structure, thought to be a vascular malformation (Fig. 1). A computed tomography pulmonary angiogram (CTPA) revealed an unusual venous drainage of the left lung. The tubular structure was a meandering unilateral single pulmonary vein draining the left upper-lobe (Fig. 2a) then tortuously descending to cross the oblique fissure and join the left lower-lobe pulmonary vein before directly merging into the left side of the left atrium (Fig.
Proving the innocence of a “malignant” coronary artery: Calling dobutamine stress CT for the defence!A 49-year-old lawyer underwent an exercise test for an insurance physical. In recovery, he had frequent premature ventricular complexes and asymptomatic runs of monomorphic non-sustained ventricular tachycardia (NSVT) not preceded by ST segment shift or chest pain, suspicious for non-ischemic, anterior fascicular VT.
Multimodality imaging of an adult with Shone complexShone complex is a rare combination of valvular or supravalvular aortic stenosis, supra-valvular mitral membrane, parachute mitral valve, and coarctation of the aorta. This article presents an unusual case of a 40-year-old woman who presented with a history of progressive dyspnea. We describe the main imaging features and protocol used for visualizing this syndrome using various imaging modalities.
Turner Syndrome with aberrant right subclavian artery and partial anomalous pulmonary venous returnWe report the case of a 6 year old girl with Turner Syndrome and Aberrant Right Subclavian Artery with an incidental finding of PAPVR on contrast-enhanced, high-pitch, 128-slice, electrocardiographic-gated dual source CT. There is value of using high-pitch DSCT in pediatric patients for diagnostic images with minimal radiation exposure.
64-Slice MDCT imaging of endocardial cushion defect associated with other cardiac and extracardiac abnormalitiesElectrocardiographic-gated 64-slice multidetector computed tomography (MDCT) was performed on a 30-year-old man who presented with a complete endocardial cushion defect (ECD) and severe pulmonary hypertension diagnosed when he was 3 years old. Multiplanar reconstruction image showed the common atrium without an atrial septum, a large ventricular septum defect, and a small right ventricle due to a complete atrioventricular canal defect. Three-dimensional CT volume-rending imaging showed a patent ductus arteriosus, dilation of the ascending aorta, and an anomalous-origin right coronary artery.
Anomalous unilateral pulmonary vein in a patient with aortic coarctationA 34-year-old woman with previous aortic coarctation repair at the age of 5 years was referred for review. She was in good health. On clinical examination, there was no blood pressure difference between the arms, but pedal pulses were weak. A contrast-enhanced 64-slice thoracic CT scan was performed to assess the coarctation repair.