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Multiple cystic aneurysms in aortitis demonstrated by three dimensional volume rendering images of multislice computed tomography
  1. N Funabashi,
  2. N Komiyama,
  3. I Komuro
  1. komuro-tky{at}

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A 29 year old man presented with slight fever and pulsation at the left neck originating from a gradually expanding palpable mass. Multislice computed tomography (CT) (Aquilion, Toshiba, Tokyo, Japan) was performed with a 1 mm slice thickness, helical pitch 5.5, and 100 ml of iodinated contrast material (300 mg/ml) delivered intravenously at a rate of 3 ml/s. An aneurysm in the left common carotid artery (LCCA) with a mural thrombus was revealed. The aortic arch, proximal portion of the descending aorta (DA) and ascending aorta (AA) appeared to be separated, as if indicating dissection of the lumen. Three dimensional volume rendering images showed collateral arteries around the anterior region of the neck and a cystic lesion from the distal aortic arch to the proximal DA after which the peripheral part of the aorta heads rightward, then downward. In axial source images at this level, the lumen of the distal portion of the aortic arch and proximal portion of the DA appears separated. Cut plane volume rendering images show distal and proximal portions of the LCCA aneurysm. Stenosis and post-stenotic dilation in the proximal portion of the left subclavian artery (LSA) are observed. Multiple cystic lesions are shown at the inferior border of the aortic arch, which in the axial images (panel D, left) appeared as aortic dissection. Thus, three dimensional volume rendering images showed the presence of multiple cystic aneurysms, but not aortic dissections. CT and blood serum studies indicated inflammation and enabled the diagnosis of aortitis, and steroid therapy was started.

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