Üst ekstremite arter psödoanevrizması BT bulguları

Özet

Travma, enfeksiyon veya arteriyel girişim sonrası arter duvarının kısmi yırtılmasıyla oluşan psödoanevrizma, lümenle bağlantılı ve çevre dokularca sınırlanmış kontrast dolu bir kese biçimindedir. Üst ekstremitede özellikle aksiller ve brakiyal arter yerleşimi, komşu nörovasküler yapılar ve el dolaşımıyla ilişkisi nedeniyle dikkatle haritalanmalıdır. BTA, üst ekstremite damarlarının açıklığını ve düzensizliklerini hızla değerlendirerek ameliyat öncesi planlama için gerekli anatomik ayrıntıyı sağlayabilir. Psödoanevrizmanın geç tanınması, ilerleyici tromboz ve distal embolizasyonun yanı sıra rüptür veya lokal kitle etkisinin fark edilmesini geciktirebilir.

Faz ve pencere

BTA tanısal: Arter komşuluğunda yuvarlak veya lobüle, kontrast dolu sakküler çıkıntı ve mümkünse ana lümene uzanan boyun görülür; kesenin kısmen tromboze bölümü kontrastlanmayan mural defekt olarak kalır.
Gecikmiş tanısal: Arteriyel fazda saptanmayan veya silik kalan aktif kanama, venöz ve gecikmiş fazları içeren çok fazlı BTA’da görülebilir.
Kontrastsız: Kontrastsız BT başlangıç yoğunluğunu gösterir; kontrastlı BT’de psödoanevrizma kesesindeki opaklaşma, komşu intramüsküler hematomların opaklaşmamasından ayrılabilir.

Önerilen pencereler: Anjiyo (G 600 / M 150), Yumuşak doku (G 400 / M 40).

BT bulguları

Sakküler kontrast çıkıntısı — aksiller veya brakiyal arter dış konturundan çıkan, lümenle aynı anda opaklaşan sınırlı kese.
Kese boynu — Psödoanevrizma kesesi arter lümeniyle iletişim kuran, perivasküler dokularca sınırlanmış bir oluşumdur; bu bağlantı keseyi damar dışı koleksiyondan ayırmaya yardımcı olur.
Mural trombüs — kese duvarı boyunca kontrastlanmayan hilal biçimli bölüm; lümenin yalnız opak kısmına bakmak kese boyutunu eksik gösterebilir.
Komşu hematom — psödoanevrizma çevresinde kan ürünü ve yumuşak doku şişliği; aktif ekstravazasyonla birlikte olabilir.
Distal embolizasyon — keseden sonra brakiyal, radial, ulnar veya dijital arterlerde fokal dolum kusuru ya da kesilme aranır.
Kitle etkisi — Psödoanevrizma veya çevresindeki hematom komşu sinir ve venlere bası yapabilir; aksiller psödoanevrizmanın brakiyal pleksusla ilişkisi özellikle değerlendirilmelidir.
Eşlik eden arteriyovenöz fistül — Psödoanevrizma ve arteriyovenöz fistül aynı olguda birlikte bulunabileceğinden, fistül olasılığı görüntülemede ayrıca değerlendirilmelidir.

Normalde

Normal aksiller ve brakiyal arterlerde dış kontur düzenlidir; lümen dışında arterle bağlantılı kontrast dolu sakküler yapı ya da mural trombüs bulunmaz. Şüpheli keseyi ana arterden ayrıldığı noktaya kadar aksiyel-koronal görüntülerde izleyin ve aynı seviyedeki karşı taraf damar konturuyla kıyaslayın; çevre hematomun boyutunu yalnız kontrast kesesine dahil etmeyin.

Ayırıcı tanı

Aktif ekstravazasyon: Arteriyel fazda kanama silik olabilir veya görülmeyebilir; venöz ve gecikmiş fazları içeren çok fazlı BTA aktif kanamanın saptanmasına yardımcı olur.
Gerçek arter anevrizması: duvarın tüm katlarıyla devamlılığı korunmuş genişlemedir; psödoanevrizmada duvar yırtığına bağlı lümen dışı kese oluşur.
Damar kesiti: Üst ekstremite BTA’sında normal damar anatomisi ve varyantlar, damar patolojisini taklit edebilir; şüpheli bulgu bu olasılık göz önünde tutularak değerlendirilmelidir.
Kontrastlanmayan hematom: kan ürünü yumuşak doku kitlesi oluşturur fakat arter yoğunluğunda opak lümen ve boyun bağlantısı göstermez.
Arteriyovenöz fistül: Arteriyovenöz fistül, psödoanevrizmayla aynı olguda bulunabilen ayrı bir vasküler lezyondur ve değerlendirmede ayrıca göz önünde bulundurulmalıdır.

Tuzaklar

Kısmi tromboz, psödoanevrizma kesesinde bulunabilir; değerlendirmede kese boyutu ile trombüs birlikte karakterize edilmelidir.
Tek aksiyel kesitte arterin kıvrımı sakküler çıkıntı gibi görünebilir; ardışık kesitlerde ve koronal-sagittal düzlemlerde damar devamlılığını takip edin.
Psödoanevrizma aktif kanamayla birlikte görülebilir; bir olguda CTA ve ultrason psödoanevrizma oluşumunu düşündürürken anjiyografi brakiyal arterden kontrast ekstravazasyonunu doğrulamıştır.
Üst ekstremite BTA’sında artefaktlar damar anormalliğini taklit edebilir veya maskeleyebilir; şüpheli damar konturunu değerlendirirken artefakt olasılığını göz önünde bulundurun.

Kendini dene

Arter duvarındaki bir açıklıktan çıkan kanın çevre dokularla sınırlanıp arter lümeniyle iletişim kurduğu kese hangi lezyondur?
Cevabı göster
Psödoanevrizma. Psödoanevrizma, arter duvarı açıklığından çıkan kanın çevre dokularca sınırlandığı ve arter lümeniyle iletişim kuran perfüze bir kese oluşturduğu lezyondur.
Brakiyal arter psödoanevrizması çevresinde hangi bulgu distal dijital iskemi kaynağını destekler?
Cevabı göster
Dijital arter dolum kusuru. Kese içindeki trombüsten kopan emboli distal dijital arterde lümen içi dolum kusuru veya kesilme oluşturabilir. Ödem ve kemik bulgusu emboliyi göstermez; açık palmar ark ise distal dolaşımın korunduğunu düşündürür.

İlgili konular

Kaynaklar

Bu sayfadaki 35 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 16 cümle bu karşılaştırmada düzeltildi (2026-10-09).

Dislocation of total hip arthroplasty prosthesis after transarterial embolization of a pseudoaneurysm: case reportpmc.ncbi.nlm.nih.gov
Upper-Limb Ischemia Due to Distal Embolization from a Dissecting Axillary Artery Pseudoaneurysm in an Elite Overhead Athlete: A Case Reportpmc.ncbi.nlm.nih.gov
Idiopathic radial artery pseudoaneurysm: A rare case in a renal transplant recipient – A case reportpmc.ncbi.nlm.nih.gov
Staged endovascular and surgical management of vertebral arteriovenous fistula with ruptured aneurysm and pseudoaneurysm in neurofibromatosis type 1 complicated by fatal reperfusion injury: illustrative casepmc.ncbi.nlm.nih.gov
Disrupted anastomotic pseudoaneurysm in arteriovenous grafts: an etiology-driven case series with a proposed preliminary management frameworkpmc.ncbi.nlm.nih.gov
Peripheral artery aneurysm.pubmed.ncbi.nlm.nih.gov
Pseudoaneurysms in haemophilia.pubmed.ncbi.nlm.nih.gov
Mycotic aneurysm of the distal radial artery after cardiac catheterisation.pubmed.ncbi.nlm.nih.gov
Percutaneous axillary artery access for fenestrated and branched thoracoabdominal endovascular repair.pubmed.ncbi.nlm.nih.gov
Retrospective Analysis of 120 Cases of Iatrogenic and Traumatic Peripheral Arterial Pseudoaneurysms.pubmed.ncbi.nlm.nih.gov
Delayed Formation of Traumatic Ulnar Artery Pseudoaneurysm Presenting With Ulnar Nerve Palsy: A Case Report.pubmed.ncbi.nlm.nih.gov
[Sudden-onset monoplegia of the upper limb due to traumatic subclavian artery pseudoaneurysm after an interval of three days from tumbling].pubmed.ncbi.nlm.nih.gov
Postradiation Extraskeletal Osteosarcoma Masquerading as an Axillary Artery Pseudoaneurysm.pubmed.ncbi.nlm.nih.gov
Endovascular repair of subclavian/axillary artery injury with a covered stent. A case report and review of literature.pubmed.ncbi.nlm.nih.gov
Axillary artery transection after recurrent anterior shoulder dislocation.pubmed.ncbi.nlm.nih.gov
Blunt Injury of the Innominate Artery: What Surprises to Expect? A Case Report.pubmed.ncbi.nlm.nih.gov
Pseudoaneurysm of the brachial artery in a four-month-old boy: diagnosis and treatment.pubmed.ncbi.nlm.nih.gov
Autogenous Femoral Vein for Secondary Repair of Subclavian Arteries: A Salvage Solution for Complex Clinical Scenarios.pubmed.ncbi.nlm.nih.gov
Forced Complete Femoral Approach for Urgent Thoracoabdominal Aneurysm Repair Using an Inner Branched Endograft.pubmed.ncbi.nlm.nih.gov
CT angiography of acute aortic syndrome in patients with chronic kidney disease.pubmed.ncbi.nlm.nih.gov
Anesthetic Considerations for Endovascular Repair of the Thoracic Aorta.pubmed.ncbi.nlm.nih.gov
Spontaneous Dissections of Bilateral Internal Carotid and Vertebral Arteries due to Intractable Vomiting.pubmed.ncbi.nlm.nih.gov
Neurovascular injuries associated with proximal humerus fractures: a review of the current literature.pubmed.ncbi.nlm.nih.gov
Delayed Pseudoaneurysm of the Subclavian Artery Following Clavicle Fracture Fixation: A Case Report.pubmed.ncbi.nlm.nih.gov
Unusual and High Origin of Terminal Branches of the Brachial Artery: A Cadaveric Study With Embryological and Clinical Correlations.pubmed.ncbi.nlm.nih.gov
Spectral Computed Tomography Angiography in Visceral Artery Aneurysms: Technical Principles and Clinical Applications.pubmed.ncbi.nlm.nih.gov
Pseudoaneurysm Versus Chronic Expanding Hematoma on MRI: Hematoma-like Lesions with Distinct Therapeutic Strategies.pubmed.ncbi.nlm.nih.gov
Aorta unveiled: the crucial role of imaging in diagnosing and managing aortic disease-a review.pubmed.ncbi.nlm.nih.gov
Superficial venous aneurysms: a case-based review.pubmed.ncbi.nlm.nih.gov
Posttraumatic pseudoaneurysm of a superficial branch of the ulnar artery: A case report.pubmed.ncbi.nlm.nih.gov
Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series.pubmed.ncbi.nlm.nih.gov
Pitfall in necrotizing pancreatitis: Organized hematoma with arteriovenous fistula mimicking a splenic artery pseudoaneurysm.pubmed.ncbi.nlm.nih.gov
Society for Cardiovascular Magnetic Resonance 2024 Cases of SCMR case series.pubmed.ncbi.nlm.nih.gov
Computed Tomography Imaging of Thoracic Aortic Surgery: Distinguishing Life-Saving Repairs from Life-Threatening Complications.pubmed.ncbi.nlm.nih.gov
Combined Post-traumatic Pseudoaneurysms of the Superior Gluteal and Aberrant Obturator Arteries: A Case Report.pubmed.ncbi.nlm.nih.gov
Iatrogenic portobiliary fistula treated with covered stent following percutaneous transhepatic biliary drainage.pubmed.ncbi.nlm.nih.gov
Delayed hepatic artery pseudoaneurysm with arterioportal fistula after penetrating liver trauma successfully treated with coil embolization: a case report and focused literature review.pubmed.ncbi.nlm.nih.gov
Complications Subsequent to Urinary Tract Stent Placement: An Overview Focusing on the Imaging of Cancer Patients.pubmed.ncbi.nlm.nih.gov
Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
Non-pulmonary postoperative complications of cardiothoracic surgery.pubmed.ncbi.nlm.nih.gov
Surgical complications after pancreatic transplantation: A computed tomography imaging pictorial review.pubmed.ncbi.nlm.nih.gov
Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography.pubmed.ncbi.nlm.nih.gov
Infected splenic artery pseudoaneurysm within a complex splenic cystic lesion: CT angiography pitfalls and surgical correlation.pubmed.ncbi.nlm.nih.gov
The imaging spectrum of myocardial infarction and its associated complications: a contemporary pictorial review of computed tomography and magnetic resonance imaging.pubmed.ncbi.nlm.nih.gov
CTA Imaging of Peripheral Arterial Injuries.pubmed.ncbi.nlm.nih.gov
Multi-detector computed tomography in the diagnosis and management of acute aortic syndromes.pubmed.ncbi.nlm.nih.gov
CT Angiography of the Upper Extremities: Review of Acute Arterial Entities.pubmed.ncbi.nlm.nih.gov
Comparison of GPT-4o With Human Performance in the Polish Vascular Surgery Specialty Examination.pubmed.ncbi.nlm.nih.gov
Multimodality imaging evaluation of arteriovenous fistulas and grafts: a clinical practice review.pubmed.ncbi.nlm.nih.gov
Late Presentation of Brachial Plexus Traction Injury After Fixation of Chronic Clavicle Nonunion Mimicking Brachial Plexitis: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
Idiopathic True Aneurysms of the Brachial Artery: A Short Case Series and Scoping Review.pubmed.ncbi.nlm.nih.gov
Neurological improvement following revision of vascular graft remnants in the upper extremity.pubmed.ncbi.nlm.nih.gov
Vascular and lymphatic complications after renal transplant.pubmed.ncbi.nlm.nih.gov
Postoperative Pulmonary Complications: Clinical and Imaging Insightspubmed.ncbi.nlm.nih.gov
2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
Cervical arteries tortuosity and its association with dissection: A systematic review and meta-analysis.pubmed.ncbi.nlm.nih.gov
Role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of peripheral nerves in the upper extremity.pubmed.ncbi.nlm.nih.gov
CT angiography findings in carotid blowout syndrome and its role as a predictor of 1-year survival.pubmed.ncbi.nlm.nih.gov
Contrast-enhanced ultrasound (CEUS) in urgent and emergent pediatric conditions: a comprehensive review.pubmed.ncbi.nlm.nih.gov
Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds.pubmed.ncbi.nlm.nih.gov
Endovascular treatment of true visceral artery aneurysms: a decade of experience and key outcomes from a high-volume single center.pubmed.ncbi.nlm.nih.gov
2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.pubmed.ncbi.nlm.nih.gov
2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.pubmed.ncbi.nlm.nih.gov
Mechanisms of aortic dissection: From pathological changes to experimental and <i>in silico</i> models.pubmed.ncbi.nlm.nih.gov
Significant incidental cardiac disease on thoracic CT: what the general radiologist needs to know.pubmed.ncbi.nlm.nih.gov
MDCT evaluation of acute aortic syndrome (AAS).pubmed.ncbi.nlm.nih.gov
Urgent and emergent pediatric cardiovascular imaging.pubmed.ncbi.nlm.nih.gov
Splenic Artery Pseudoaneurysms: The Role of ce-CT for Diagnosis and Treatment Planning.pubmed.ncbi.nlm.nih.gov
Society for Cardiovascular Magnetic Resonance/European Society of Cardiovascular Imaging/American Society of Echocardiography/Society for Pediatric Radiology/North American Society for Cardiovascular Imaging Guidelines for the use of cardiovascular magnetic resonance in pediatric congenital and acquired heart disease : Endorsed by The American Heart Association.pubmed.ncbi.nlm.nih.gov
Pulmonary artery involvement contributes to the recurrence of hemoptysis after bronchial artery embolization in patients with chronic pulmonary aspergillosis.pubmed.ncbi.nlm.nih.gov
Visceral Arterial Pseudoaneurysms-A Clinical Review.pubmed.ncbi.nlm.nih.gov
Management of spontaneous abdominal wall hematomas: a narrative review with a focus on CTA-negative endovascular cases.pubmed.ncbi.nlm.nih.gov
Multimodality Imaging of Thoracic Outlet Syndrome: Etiological and Anatomical Correlates.pubmed.ncbi.nlm.nih.gov
Diagnostic and Therapeutic Approach to Thoracic Outlet Syndrome.pubmed.ncbi.nlm.nih.gov
Cystic lesions and their mimics involving the intrahepatic bile ducts and peribiliary space: diagnosis, complications, and management.pubmed.ncbi.nlm.nih.gov
Life-threatening Carotid Complications Caused by Extraluminal Migration of Ingested Foreign Bodies; a Case Report and Narrative Review of Literature.pubmed.ncbi.nlm.nih.gov
Utility of contrast enhanced ultrasound (CEUS) in penile trauma.pubmed.ncbi.nlm.nih.gov
Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair.pubmed.ncbi.nlm.nih.gov
Cardiothoracic Applications of 3-dimensional Printing.pubmed.ncbi.nlm.nih.gov
Long-term safety and effectiveness of the "OptEase" vena cava filter.pubmed.ncbi.nlm.nih.gov
CT-Centered Multimodality Imaging of Arterial Wall Fragility in Acute Aortic Syndromes: A Narrative Review of Imaging Markers and Clinical Implications.pubmed.ncbi.nlm.nih.gov
A modified technique for radial artery access: how interventional radiologists can optimise the cardiologists' technique to suite their procedures.pubmed.ncbi.nlm.nih.gov
Roles of Trauma CT and CTA in Salvaging the Threatened or Mangled Extremity.pubmed.ncbi.nlm.nih.gov
Beyond the Usual Suspects: Rare Causes of Hemoptysis.pubmed.ncbi.nlm.nih.gov
Progressive thrombosed pseudoaneurysm following transarterial balloon embolization in traumatic carotid-cavernous fistula: From silent lesion to symptomatic mass.pubmed.ncbi.nlm.nih.gov
A review of histopathologic and radiologic features of non-atherosclerotic pathologies of the extracranial carotid arteries.pubmed.ncbi.nlm.nih.gov
Staged endovascular and surgical management of vertebral arteriovenous fistula with ruptured aneurysm and pseudoaneurysm in neurofibromatosis type 1 complicated by fatal reperfusion injury: illustrative case.pubmed.ncbi.nlm.nih.gov
Disrupted anastomotic pseudoaneurysm in arteriovenous grafts: an etiology-driven case series with a proposed preliminary management framework.pubmed.ncbi.nlm.nih.gov
Case Report: Renal artery aneurysm rupture, axillary artery pseudoaneurysm, and catastrophic intraperitoneal hemorrhage caused by fibromuscular dysplasia with the involvement of multiple arterial beds.pubmed.ncbi.nlm.nih.gov
Cardiac tamponade following endovascular therapy due to acute aorto-caval leakage after superior vena cava stenting in tuberculosis mediastinal fibrosis.pubmed.ncbi.nlm.nih.gov
Imaging in the postpartum period.pubmed.ncbi.nlm.nih.gov
Case Report: Acute Testicular Pain as the Initial Manifestation of a Ruptured Common Iliac Artery Aneurysm.pubmed.ncbi.nlm.nih.gov
Inflammatory Aortopathies in Rheumatic Diseases: A State-of-the-Art Review.pubmed.ncbi.nlm.nih.gov
First clinical experience with the surpass elite flow diverter in the treatment of intracranial aneurysms.pubmed.ncbi.nlm.nih.gov
Axillary Artery Pseudoaneurysm Secondary to Septic Shoulder After Trauma: A Review of Incidence and Outcomes.pubmed.ncbi.nlm.nih.gov
Cephalic Venous Aneurysm and Intravascular Papillary Endothelial Hyperplasia in a Blood Donor.pubmed.ncbi.nlm.nih.gov
Massive subcapsular hepatic haematoma after laparoscopic cholecystectomy managed by transarterial embolization.pubmed.ncbi.nlm.nih.gov
Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.pubmed.ncbi.nlm.nih.gov
Imaging of cardiac valves by computed tomography.pubmed.ncbi.nlm.nih.gov
Cadaveric Report of an Unusual Axillary Artery Branching Variation: A Potential Compression Site for the Lateral Root of the Median Nerve.pubmed.ncbi.nlm.nih.gov
From imaging to impact: A case of renal arteriovenous malformation.pubmed.ncbi.nlm.nih.gov
Arc of Buhler pseudoaneurysm complicated by an arterioportal fistula: a combined endovascular and open surgical approach.pubmed.ncbi.nlm.nih.gov
Pneumothorax and Hemothorax: Practical Approaches for Radiologists.pubmed.ncbi.nlm.nih.gov
Radiologic Interventions for Gastrointestinal Bleeding.pubmed.ncbi.nlm.nih.gov
Traumatic intracranial pseudoaneurysms of cortical middle cerebral artery and posterior cerebral artery branches presenting as subdural hematomas in elderly patients: A two-case report.pubmed.ncbi.nlm.nih.gov
Compression Syndromes of the Stylohyoid Complex: Neural, Arterial, and Venous Phenotypes in a Dynamic Neurovascular Corridor.pubmed.ncbi.nlm.nih.gov
Craniofacial speargun injuries: report of three cases, literature review and proposed management guidelines for maxillo-facial surgeons.pubmed.ncbi.nlm.nih.gov
Contemporary Multi-modality Imaging of Prosthetic Aortic Valves.pubmed.ncbi.nlm.nih.gov
Endovascular management of iliac vessel injury complicating lumbar disc surgery: a case report and review of literature.pubmed.ncbi.nlm.nih.gov
Endovascular treatment of congenital descending aorta coarctation complicated by multiple tandem spinal artery aneurysms: a case report and literature review.pubmed.ncbi.nlm.nih.gov
Role of Cardiac CT in the Evaluation of Valvular Heart Disease.pubmed.ncbi.nlm.nih.gov
Ureteroarterial Fistula Secondary to External Iliac Artery Pseudoaneurysm in a Patient With Metastatic Colon Cancer.pubmed.ncbi.nlm.nih.gov
Transarterial Embolization for Malignancy-Related Gastrointestinal Bleeding: Outcomes with and Without CT Extravasation.pubmed.ncbi.nlm.nih.gov
Pseudoaneurysms: Different ultrasound patterns, aetiologies and locations.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.