[The left superior intercostal vein (author's transl)]

Study on the LSIV has several points of value: It enters into the normal mediastinal outline, forming the aortic "nipple". It may be the site of dilatation, either congenitally or secondary to haemodynamics changes. This venous dilatation should not be confused with a mediastinal tumour. It forms, in the majority of cases, an anastomosis between the superior vena cava and the azgos vein and therefore plays a part in the collateral circulation of caval obstruction syndromes. Its transverse course explains its involvement in the anterior and posterior mediastinal syndromes. Opacification of the LSIV should be part of the study of mediastinal tumours. By virtue of its relations with the left upper lobe, its study should be part of the pre-therapeutic assessment of such lesions.

Critical review of tomography in radiology and nuclear medicine

This review covers conventional radiographic tomography, radioisotopic tomography, and a review of computerized transaxial tomography. Simple, reproducible radiographic tomographic methods are increasing in use, and despite their complexity, the diagnostic results are superior to conventional radiographs. There are many different motions of the X-ray tube and the film which can be employed to create a tomogram. The perfect tomographic motion is partly determined by the geometric shape of the object to be imaged and the thickness of the plane of interest. The undirectional tomographic method blurs a point in a linear fashion; the pleuridirectional method blurs a point over a wider surface. Among the most popular directions used are linear, circular, elliptical, and hypocycloidal. The numerous applications of tomography described in this review are an encouraging, broad-based foundation from which the most clinically useful and economically feasible devices will emerge.

Spinal arteriovenous malformation with hypogastric blood supply. Case report

✓ A report of a patient with a spinal arteriovenous malformation (AVM) supplied from the right hypogastric artery is presented to emphasize the importance of thorough angiographic investigation when a spinal AVM is suspected.

Ocular findings in patients with arteriovenous malformations of the head and neck

The hospital charts of 71 patients with congenital arteriovenous malformation of the head or neck, excluding carotid-cavernous sinus fistulas, yiedled 25 patients, referred to the ophthalmology service for examination. Of these, 22 patients had ocular findings; additionally, 12 patients with visual complaints or ocular findings were not referred for ocular examination. Forty-seven percent of all patients had ocular signs and symptoms including subjective visual complaints, visual field loss, ophthalmic artery pressure changes, nystagmus and motility findings, orbital and ocular vascular abnormalities, and fundus changes including optic atrophy, hypoxic retinopathy, and papilledema. Every patient with known or suspected arteriovenous malformation of the head or neck should have a thorough ocular examination. The findings can generally be correlated with the anatomic location and size of the lesion.

[Foramen retroarticulare atlantis and the vertebral angiogram (author's transl)]

The incidence of a foramen retroarticulare atlantis in a group of 380 patients was investigated and put in relation to the frequency of headaches, migraine and Meniere's syndrome. These complaints are found more frequently in patients with a retroarticular foramen. Angiograms of the vertebral artery show vascular constrictions in the region of the foramen retroarticulare in the majority of patients examined. In 5 patients, the clinical symptoms of a mechanical irritation with changes in blood flow through the vertebral artery in the region of a foramen retroarticulare atlantis have been described.

Echocardiographic findings in right coronary arterial-right ventricular fistula. Report of a neonate with fatal congestive heart failure

Coronary arteriovenous fistula is a rare cause of congestive heart failure in the newborn. We describe a 2 day old infant with a large fistula between the right coronary artery and right ventricle that caused fatal congestive heart failure. An echocardiographic study revealed a large right ventricle, paradoxical motion of the interventicular septum and an enlarged aorta, suggesting an unusual location of a left to right shunt. The diagnosis was established at cardiac catheterization when a large left to right shunt was found at the ventricular level; the fistula was visualized by angiography.

[Disturbances of pulmonary ventilation in association with cardiac disease in infants (author's transl)]

Numerous causes exist for disturbances in pulmonary ventilation in the newborn and infant. Amongst the exobronchic causes, those of cardiovascular origin are not rare. The difficulty in radiological diagnosis varies in relation with the anatomo-radiological appearance of the lesions and their aetiology. Ventilation disturbances are not always obvious. Simple techniques (high penetration films, oblique views, films in inspiration and expiration) make possible the topographical localisation of the lesions and the detection of any obstructive factor. These films should also be adequate as far as the aetiological diagnosis is concerned: severe left-right shunt, pulmonary valve agenesis, fibro-elastosis, retrotracheal left pulmonary artery. Obviously, angiocardiography is often necessary to confirm and accurately determine the nature of the "cardiovascular" lesion responsible. Such disturbances of pulmonary ventilation may either reveal or complicate a cardiac or vascular disorder in the newborn or infant. They often present marked therapeutic problems.

Congenital renal arteriovenous malformation: angiography in its diagnosis

Two patients with renal arteriovenous malformations are presented along with the distinct changes shown by urography, arteriography, and pharmacoangiography. The relevant roentgen signs in such patients include multiple small cobblestone-like identations caused by well-formed vascular channels projecting into the collecting structures, no angiographic or urographic evidence of a mass displacing the intrarenal vessels or collecting structures, normal sized arteries and veins leading to and from the malformation, and a decrease in size of the malformation after intra-arterial infusion of epinephrine. These patients may have flank pain or hematuria later in life or may remain asymptomatic. A complete urographic and angiographic examination will help to determine the appropriate therapy. Corrective surgery is usually reserved for symptomatic patients and, when indicated, require only surgical ligation of the vessels feeding and draining the malformation.

Vascular radiological procedures in orthopedic surgery

Angiographic procedures are valuable in the analysis of trauma, postoperative situation, congenital lesions, tumors, and vascular conditions producing bone and soft tissue alterations. Angiography following trauma is most helpful in determining the status of the integrity of vessels when the clinical findings are not clear, when a vascular lesion without obstruction is suspected, to establish the status of distal vessels following repair of a proximal injury and to evaluate multiple injuries in the same limb. Vascular damage is possible even when the overlying soft tissue has not been lacerated. Embolization techniques to control hemorrhage have been recently developed. Immediate or delayed effects of intraoperative damage to the vessels can be verified by angiography. Most commonly traumatic arteriovenous communications and pseudoaneurysms are discovered by angiographic means. Congenital vascular lesions may be classified as localized arteriovenous malformations, small vessel arteriovenous malformations, diffuse arteriovenous malformations, or venous malformations. Angiography localizes and defines the extent of such lesions. Skeletal or muscular congenital anomalies secondarily involving the vessels can best be defined by angiographic means. Angiography of tumors is most helpful in defining the location and extent of tumors and the site for most productive biopsy. With rare exceptions, the angiogram is not helpful in defining the histologic nature of the lesion. The angiographic studies are most helpful in lesions involving the pelvis and retroperitoneal spaces. Vascular diseases producing bone and soft tissue alterations can best be defined as to extent by angiographic means. In particular, the diabetic patient with limb ischemia should be afforded the benefit of an arteriogram to establish the presence or absence of any surgically remedial lesions in the proximal vascular supply to the limb.

Internal mammary arteriovenous malformation with communication to the pulmonary vessels

A 25 year old asymptomatic man with a past history of pulmonary tuberculosis presented with a continuous murmur. Selective arteriography revealed a left internal mammary arteriovenous malformation in communication with vessels in the left upper pulmonary lobe. No significant hemodynamic abnormalities were detected. This is the 26th reported case of internal mammary arteriovenous fistula and the 6th with a pulmonary communication. Review of the data in previous cases suggests that surgical indications are limited to symptomatic relief, heart failure during infancy or the possible risk of endarteritis, proximal arterial degeneration or rupture.

Congenital arteriovenous malformations of the uterus demonstrated by angiography

Two cases of congenital arteriovenous malformations of the uterus are described, with details of their angiographic and operative identification. The condition is rare, but should be considered in cases of severe uterine haemorrhage when more routine investigations have been normal.

Intraparenchymal arteriovenous malformations with predominant external carotid artery contribution

✓ Arteriovenous malformations located within cerebral parenchyma are usually supplied by intracranial vessels. An extracranial blood supply to these lesions is rare. The authors report their experience with two such cases and discuss the 21 comparable reports.