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Kommerell’s diverticulum (KD) is a rare aneurysm of the origin of an aberrant subclavian artery. Hybrid aortic arch repair for KD is being performed more often. We report hybrid arch repair for KD in a 63-year-old man with a right aortic arch and aberrant right vertebral artery, an extremely rare variant. We performed total arch replacement to completely reconstruct the five cervical arteries with elephant trunk to create an adequate landing zone, followed by second-stage endovascular stent-grafting from the ascending aorta to the proximal descending aorta.

Objectives: Renal scintigraphy is widely used to evaluate residual function of a transplanted kidney from the donor. Dynamic computed tomography (CT) imaging can evaluate both kidney morphology and regional renal function. The aim of this study was to develop an imaging protocol and a calculation method using dynamic CT for assessing the effective renal plasma flow (ERPF) by model analysis, and to evaluate the validity of the obtained ERPF values. Methods: Preoperative dynamic CT examination with a low radiation dose exposure system was performed for 25 renal transplant donors, and ERPF was calculated from the obtained images (CT-ERPF). To calculate CT-ERPF, we set the region of interest (ROI) in the renal cortex using automatic ROI-setting software developed in our laboratory. We compared the processing time with automatic and manual ROI settings. To evaluate the validity of CT-ERPF, we examined the correlation of age with CT-ERPF and compared with reported ERPF values. We also compared the uptake rates of technetium-99m-dimercaptosuccinic acid and CT-ERPF in terms of the right-to-left ratio. Results: There was good agreement of CT-ERPF assessed using automatic and manual ROIs. CT-ERPF was negatively correlated with age and showed values below the reference ERPF range in 21 cases. The right-to-left ratio of CT-ERPF showed a significant correlation with that of technetium-99m-dimercaptosuccinic acid. Conclusions: Using our method, CT-ERPF was a useful indicator for preoperative evaluation of donor’s renal function.

We herein report a relatively rare case of an inflammatory myofibroblastic tumor (IMT) of the bladder in a young woman. In contrast to IMTs of other organs, IMTs of the lower urinary tract involve the mixture of a non-neoplastic lesion with a neoplastic lesion; therefore, the determination of whether other neoplastic lesions are present is important. In this case, magnetic resonance imaging confirmed a pedunculated lobulated tumor that protruded from the posterior left bladder wall into the lumen. The lobulated area exhibited a low-intensity signal on T1-weighted imaging (T1WI) and a high-intensity signal similar to that of urine on T2-weighted imaging (T2WI). Morphologically, the peduncle resembled a submucosal mass with faint low-intensity signaling on T1WI and faint high-intensity signaling on T2WI. These findings differ from those of a neoplastic lesion of the bladder mucous membrane. The presence of lesions from the muscularis propria to the submucosa and in areas with markedly high-intensity signals exhibiting a nodular fasciitis pattern on T2WI is considered useful for the differential diagnosis of IMT on imaging examination.