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Objectives: To evaluate the effect of superselective renal artery embolization in terms of renal function and blood pressure, to compare the results between groups with different embolization extents, and to analyze risk factors of entire study population for postprocedural acute kidney injury (AKI). Materials and Methods: The inclusion criteria were patients who underwent renal artery embolization from January 2009 to December 2019, with available serum creatinine and blood pressure data. The exclusion criteria were non-selective embolization of main renal artery, AKI before embolotherapy, and follow-up of less than one month. According to the extent of embolization, the patients were divided into two groups: Group A (1 segment) and Group B (2–4 segments). Results: A total of 48 patients were enrolled. There was a significant difference between pre- and postprocedural estimated glomerular filtration rate ('p' = 0.030). There were no significant difference between pre- and postprocedural blood pressure. The incidence of postprocedural AKI in group B was significantly higher than that in group A ('p' = 0.044). There was no significant difference in the incidence of the worsening of hypertension between the two groups. Chronic kidney disease and high embolization grade were predictive for postprocedural AKI ('p' = 0.012, 0.021). Conclusion: Superselective embolization appears to be a safe procedure, but meticulous attention for AKI is required for patients who underwent embolization of more than one segmental artery. An attempt to minimize the extent of devascularization should be pursued to avoid postprocedural complications.

To determine the efficacy of a percutaneous sharp needle recanalization technique for the treatment of peripheral hemodialysis arteriovenous fistula (AVF) occlusion. This study included 13 patients (14 procedures) between May 2010 and February 2020 with non-thrombotic AVF occlusion wherein guidewire passage through the occluded segment had failed. We successfully passed the guidewire through the occluded segment using a sharp needle recanalization technique with Chiba or Colapinto needles, under ultrasound or fluoroscopic guidance. The type of AVF, site and length of occlusion, technical success, complications, and long-term patency were analyzed. Technical success was achieved in 12 (85.7%) out of 14 procedures. The procedure failed in two patients due to the poor angle of approach in the axillary area and diffuse severe stenosis in the draining cephalic vein. In eight procedures, sharp needle recanalization was performed under ultrasound guidance, while the other six procedures were performed under fluoroscopic guidance. Chiba and Colapinto needles were used in five and nine procedures, respectively. The mean length of occlusion was 2.7 cm (range 1.8–4.2 cm). There was one case of mild complication, that is, mild contrast extravasation, which was treated by stent deployment. The post-intervention primary patency rates at 6 months, 1 year, and 2 years were 81.8%, 36.4%, and 18.2%, respectively. The results of this limited series suggest that the sharp needle recanalization technique is a simple and effective method for the treatment of peripheral non-thrombotic AVF occlusion.

To evaluate the incidence, management methods and follow-up results of arterial embolism during percutaneous thrombectomy of hemodialysis grafts. After Institutional Review Board approval, the radiologic database of our department for percutaneous thrombectomy procedure in hemodialysis access was retrospectively reviewed. Between 1998 and June 2014, 2975 percutaneous thrombectomy procedures using thromboaspiration technique were performed in 1524 patients with thrombosed hemodialysis grafts. After thrombectomy, angioplasty was performed for significant stenoses. The incidence of arterial embolism was analyzed according to the location/shape of the arteriovenous graft. Percutaneous management methods of arterial embolism and long-term follow-up results by fistulography were also evaluated. Arterial embolism was documented by angiography in 117 cases (3.9%). Of these, three were symptomatic and subsided after embolectomy. The incidence was significantly correlated with the location/shape of the graft (p = 0.001). Arterial emboli were retrieved using occlusion balloon/Fogarty balloon (n = 58), guiding catheter-assisted aspiration (n = 36), sheath-assisted aspiration (n = 2) and back-bleeding technique (n = 3). Others were observed without intervention (n = 17) or surgically removed (n = 1). Arterial emboli were completely retrieved in 86 cases and partially retrieved in 13 cases. Ulnar artery rupture occurred in one case due to over-inflation of the occlusion balloon. Follow-up fistulography performed in 60 patients among whom 99 percutaneous embolectomies were done revealed arterial stenosis/occlusion in 7 and residual emboli in one patient. In observed patients without intervention, follow-up documented complete resolution of the emboli without arterial stenosis in 9 patients. Radiologically perceivable arterial embolism is uncommon during percutaneous thrombectomy of thrombosed dialysis grafts. The majority of the emboli can be retrieved by percutaneous techniques, but may induce arterial damage in some patients. Clinical observation can be another option for patients without ischemic symptoms.

Background: Endovascular treatments such as percutaneous transluminal angioplasty (PTA) and stent placements are becoming the standard method in managing haemodialysis access failure. Venous rupture is the most common complication during endovascular procedures. Complications during endovascular treatments of central venous stenosis or occlusion have been rarely reported. Objectives: To investigate the incidence and management of central vein rupture while performing PTA for central vein stenosis or occlusion in haemodialysis patients. Method: Between 1998 and 2013, PTA was performed using various techniques in haemodialysis patients for central vein stenoses ( n = 2437) and occlusions ( n = 666). When the guide wire passed through the stenosis or the occlusion, PTA was performed regardless of the presence of a venous rupture. The incidence of central vein rupture was analysed using the chi-square test according to the gender, location, right versus left, presence of thrombosis and stenosis versus occlusion. Percutaneous management of central vein rupture was also evaluated. Results: Central vein rupture occurred in 12 cases (0.39%). All ruptures occurred in the cases with occlusion. Only stenosis versus occlusion reflected a significant correlation ( p < 0.001) with central vein rupture. Central vein ruptures were managed by low-pressure balloon tamponade ( n = 2), stent/stent-graft ( n = 5) and balloon-mediated haemostasis blocking venous inflow followed by the observation ( n = 5). Conclusion: Central vein rupture is a rarely occurring complication while performing PTA for central vein stenosis and occlusion, and the majority can be successfully managed by percutaneous techniques.

Purpose To evaluate effectiveness of percutaneous transluminal angioplasty (PTA) for transposed brachiobasilic arteriovenous fistula (tBBAVF), and to analyze the factors influencing patency after PTA. Materials and Methods In 101 patients who underwent operation for tBBAVF from January 2006 to February 2008, we identified 42 patients undergoing PTA. We conducted a retrospective analysis of sequential PTAs in these patients from 2006 to 2017. Results A total of 100 PTAs were performed. The technical success rate was 93% and the clinical success was 100%. Only ruptures occurred in 12% as minor complications. Primary patency rate was 61%, 29%, 7%, and secondary patency was 91%, 82%, 59% at 6, 12, and 24 months, respectively. Primary patency rate was lower in tBBAVF with rupture (p = 0.024). Secondary patency rate was significantly lower in the diabetes (p = 0.002). Conclusion Repetitive PTAs in tBBAVF are acceptable due to excellent secondary patency. Primary patency of tBBAVF is low in patients with rupture. Diabetes itself has a significant effect on secondary patency.

Background Central vein stenosis or occlusion is a common complication that can lead to significant morbidity and dysfunction of access in the hemodialysis patient. More lesions can develop over time, and preserving access becomes a challenge as life expectancy of the hemodialysis patient increases. Objectives The goal was to compare long-term results and determine the outcomes of open-cell stent versus closed-cell stent for central vein stenosis or occlusion in hemodialysis patients. Patients and methods From 1997 to 2015, in 401 hemodialysis patients, stent placement for central vein stenosis or occlusion was performed if balloon angioplasty was unsatisfactory, due to elastic recoil or occurrence of restenosis within 3 months. When thrombus was present, primary stenting was performed. A total of 257 open-cell stents and 144 closed-cell stents were used. Angiographic findings including lesion site, central vein stenosis or occlusion, and presence of thrombosis and complication were evaluated. Primary patency rate and mean patency rate of the stent were compared between two stent groups by Kaplan-Meier survival analysis. Results For the open-cell stent group, 159 patients were diagnosed as central vein stenosis and 98 were occlusion. For the closed-cell stent group, 78 were stenosis and 66 were occlusion. There were two complications for central migration and two for procedure-related vein rupture. Open-cell stents and closed-cell stents had mean patency rates of 10.9 ± 0.80 months and 8.5 ± 10.87 months, respectively (P = 0.002). Conclusion The open-cell stent is effective and its performance is higher than that obtained with the closed-cell stent for treating central vein stenosis or occlusion in hemodialysis patients.

To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child's status (B-HVPG, P0.000; EH-HVGP, P0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger correlation than EH-HVPG.

The uterus is the major female sex organ and is essential for pregnancy. The organ is located in the pelvic cavity. It is usually fist-sized with its volume changing from 75 to 200 cc depending on the menstrual cycle. There are various diseases associated with the uterus, including malignancy, uterine myoma, postpartum hemorrhage, and vascular malformation. The conventional surgical treatment for these diseases is hysterectomy. However, hysterectomy has some risk, and there may be complications associated with the surgery and anesthesia. In addition, hysterectomy results in loss of fertility and loss of female characteristics, both of which may lead to emotional problems. After uterine artery embolization (UAE) was performed for post-partum bleeding in 1979 and for uterine myoma in 1995, interventional treatment of UAE replaced the existing surgical treatment of hysterectomy. UAE is performed widely as a minimally invasive treatment modality that can preserve the uterus, make pregnancy and childbirth possible and resolve emotional problems. The interventional treatment has become increasingly popular to treat various female genital diseases

Purpose The purpose of this study was to evaluate the feasibility, efficacy and safety of percutaneous thromboaspiration with a 7F Desilets-Hoffman sheath compared with previously established percutaneous mechanical thrombectomy techniques in occluded hemodialysis grafts. Materials and Methods One thousand three hundred five patients (767 women, 538 men; mean age, 61.04±13.09 years; mean graft age, 36.64±30.80 mo) with 2,531 episodes of hemodialysis graft thrombosis underwent percutaneous thromboaspiration with a 7F Desilets-Hoffman sheath using criss-cross or apex puncture technique. Technical success rate, procedure time, complications and patency rates were analyzed. Results Technical success was achieved in 2,426 of 2,531 procedures (95.9%). Average procedure time of the intervention was 42.87±22.77 minutes. Primary patency rate was 61.9% at 3 mo, 41.2% at 6 mo and 19.6% at 1 year. Major complications occurred in 4.1% of cases (23 graft outflow rupture; 68 arterial emboli; 1 arterial dissection; 3 symptomatic pulmonary embolism; 1 stent migration) and minor complications occurred in 7.7% of cases (196 cases). These results were comparable to previously reported mechanical thrombectomy techniques in occluded hemodialysis grafts. Conclusions Percutaneous thromboaspiration of occluded hemodialysis grafts with a Desilets-Hoffman Sheath is an effective and safe method.

ercutaneous declotting is the preferred method for the treatment of thrombosedW hemodialysis arteriovenous fistulae and grafts (1–3). A variety of different declotting methods have been de-veloped for clinical use, including pulse-spray pharmacomechanical thrombolysis (3, 4), mechanical thrombectomy (using Amplatz Clot Buster, AngioJet, or Arrow percutaneous thrombolytic device) (4–7), and aspiration thrombectomy (8). In general, two separate puncture sites are required to enter the arterial and venous limbs of the graft for declot-ting. An alternative approachc for declotting is to perform percutaneous catheterization of a thrombosed loop hemodialysis graft using the apex-puncture technique (9). This involves gaining single access at the loop graft apex to access both the venous and arterial limbs for clot removal, angioplasty of the anastomotic stenosis, and finally removal of the ar-terial plug. However, its advantages are limited in controlling intimal hyperplasia and residual thrombi at the peri-sheath/graft apex. Apical residual thrombi in the peri-sheath zone can be washed away spontane-ously; however, in some cases, removal requires a second sheath inser-tion. In this study, we used the Fogarty balloon application technique, whereby the Fogarty balloon is used to compress or displace the peri-sheath, apical residual thrombi.Here, we describe a simple technique for the removal of residual thrombus at the graft apex during ther apex puncture procedure to declot occluded loop hemodialysis grafts. We believe that this technique may help to resolve the problems of apex puncture technique.

The purpose of this study was to evaluate our experience with the use of a Rösch-Uchida needle technique to recanalize central vein occlusion that cannot be traversed with a guidewire.We retrospectively evaluated 33 recanalization procedures performed with a Rösch-Uchida needle on 20 men and 13 women with central vein occlusion during the period January 1999-December 2008. The occlusions were in the subclavian vein (n = 29) and the brachiocephalic vein (n = 4). A 9- or 10-French Rösch-Uchida introducer sheath was advanced centrally to abut the occlusion. The Rösch-Uchida needle was directed and advanced toward a transfemoral angiographic catheter placed on the central side of the occlusion. After passage of a guidewire through the occlusion, balloon angioplasty and stent insertion were performed. The outcome measures evaluated were technical success rate, primary and secondary patency, and complication rate.The mean occlusion length was 1.73 +/- 0.8 cm. The rate of technical success of recanalization was 93.9% (31 of 33 procedures). The 3-, 6-, and 12-month primary patency rates were 43.6%, 24%, and 8%, and the 3-, 6-, and 12-month secondary patency rates were 77.4%, 68.8% and 55.9%. One patient reported shoulder pain lasting 2 weeks, which resolved with conservative treatment.Use of a Rösch-Uchida needle to recanalize central vein occlusion refractory to a traditional procedure is feasible and safe and can preserve the involved extremity for long-term hemodialysis.

Background: Prognostic factors of breast cancer have been used for the prediction of clinical outcome or selection of patients for complementary treatment. Some of the imaging features of breast cancer, e.g. magnetic resonance imaging (MRI), are associated with these prognostic factors. Purpose: To evaluate the relationship between dynamic enhanced MR features and prognostic factors of clinical outcome of breast cancer. Material and Methods: A total of 136 patients with 151 breast cancers underwent 1.5T dynamic MR imaging with the use of a dynamic T1-weighted three-dimensional fast low-angle shot (FLASH) subtraction imaging technique. Morphological and kinetic analyses of MR features were evaluated using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon. Pathological prognostic factors were correlated with MR imaging characteristics, including tumor size, histological grade, lymph node status, expression of estrogen receptor (ER), expression of progesterone receptor (PR), expression of c-erbB2, determination of Ki-67 index, and microvascular density (MVD), using univariate and multivariate statistical analyses. Results: Based on univariate and multivariate analyses, spiculated tumor margins correlated significantly with lower histological grade (I–II) and positive PR expression. Rim enhancement was significantly correlated with high histological grade, presence of axillary lymph node metastasis, large tumor size, increased Ki-67 index, and increased MVD. Early peak enhancement, as seen on the first scan after contrast medium injection, was correlated with negative ER expression. Conclusion: The presence of a lesion with a spiculated margin may predict a relatively good prognosis, and the presence of a lesion with rim enhancement may predict a relatively poor prognosis.

A 67-year-old woman with end-stage renal disease presented with profound edema of both breasts. The presence of a patent hemodialysis basilic transposition fistula and superior vena cava obstruction (SVC), due to fibrosing mediastinitis, was demonstrated by the use of fistulography. Endovascular treatment with a balloon and stent caused immediate resolution of the breast edema.

Interstitial ectopic pregnancy is a rare condition of pregnancy and may be very dangerous if not identified and treated urgently. We report a case of successful treatment of an interstitial pregnancy using selective uterine artery embolization. A 27-year-old woman with interstitial pregnancy was treated by uterine artery embolization after failure of systemic methotrexate treatment. Her serum beta-human chorionic gonadotropin (beta-hCG) was undetectable one month after the therapeutic embolization and transvaginal sonography 31 days after embolization showed normal endometrium and cornu. The patient achieved a normal pregnancy eight months after embolization.

Objective. The purpose of this study was to subdivide the types of sonographic findings of benign versus malignant cystic masses and to determine appropriate patient care according to the sonographic findings with pathologic correlation. Methods. The sonographic findings of 175 symptomatic cystic breast lesions were pathologically proven and reviewed retrospectively. Cystic lesions were classified as 6 types: simple cysts (type I), clustered cysts (type II), cysts with thin septa (type III), complicated cysts (type IV), cystic masses with a thick wall/septa or nodules (type V), and complex solid and cystic masses (type VI). Sonographic findings were compared with the pathologic results and were evaluated according to the incidence of benign and malignant masses. Results. All 23 type I, 15 type II, 22 type III, and 35 type IV cases were pathologically proven to be benign. Seven (25.9%) of the 27 type V cases and 33 (62.3%) of the 53 type VI cases were proven to be malignant. We analyzed the shapes and margins of 80 cases of cystic masses with a solid component (types V and VI); 16 (44%) of 36 sonographically circumscribed masses were malignant. Conclusions. Because the sonographically detected simple cysts (type I), clustered cysts (type II), and cysts with thin septa (type III) were all benign, annual routine follow-up appears reasonable. Symptomatic complicated cysts (type IV) should be aspirated and appropriately treated according to clinical symptoms. Cystic masses with a solid component (types V and VI) should be examined by biopsy with pathologic confirmation. Key words: breast; cystic mass; sonography.

Although many women participate in breast screening programs, multidetector computed tomography (MDCT) often provides the first images of the breast when patients undergo chest MDCT for evaluation of pulmonary or cardiac disease (14). Since an MDCT scan provides improved contrast resolution, a larger field of view, and has cross sectional capability, breast lesions may be viewed more easily with a MDCT scan (1, 5, 6). With the increasing use of MDCT, a growing number of unexpected breast abnormalities of uncertain clinical significance have been observed. In practice, few studies have demonstrated the significance of incidentally detected breast lesions on MDCT (3, 4). The purpose of this study was to evaluate the significance of incidentally detected breast lesions during assessment of chest related symptoms on a chest CT scan.

differentiation of a cyst from a solid lesion (1, 2). Cystic breast lesions may be associated with numerous pathological entities, but malignant cystic breast masses are rare. Mixed cystic and solid carcinomas of the breast are uncommon findings and constitute 0.3% to 2.0% of all breast carcinomas (2, 3). There are three situations in which a cystic lesion can be associated with malignancy described as an invasion of a carcinoma into an area of cystic disease, cystic degeneration of a high-grade malignancy, and the presence of an intracystic papillary carcinoma (3). Berg et al. (2) described the sonographic and pathologic correlations of cystic lesions of the breast in which 23% (18/79) of the complex cystic masses were found to be malignant. It is suggested that 67% (12/18) of sonographically circumscribed cystic masses were malignant and that sonography may be helpful in identifying those circumscribed masses that merit a biopsy. A malignant cystic mass of the breast can be seen with a circumscribed margin on imaging. Circumscribed cancers of the breast are listed as infiltrating ductal carcinomas not otherwise specified (IDC-NOS), mucinous carcinomas, medullary carcinomas, papillary carcinomas, phyllodes tumors and adenoid cystic carcinomas (4). Imaging findings of various malignant cystic breast masses with pathological correlations are illustrated. Knowledge of the disease spectrum, as well as the characteristics of malignant cystic masses, may be helpful in the selection of whether to perform a biopsy as part of patient management. J Korean Soc Radiol 2011;64:273-279

Axillary lymphadenopathy has multiple variable pathologic conditions such as a malignant or benign condition. It is important that we determine the radiologic findings of malignant lymphadenopathy and in turn determine the further course of evaluation for the lesion, because metastatic axillary lymphadenopathy represents an important prognostic factor. Recently, an ultrasonographic-guided axillary lymph node biopsy has been widely used as a diagnostic tool. We discuss the radiologic and pathologic findings of variable axilla diseases and outline the specific findings for determining the results of a lymph node biopsy.

Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization.

Purpose: To evaluate the early ultrasonographic (US) findings from the uterus and myoma after a uterine fibroid embolization (UFE). Materials and Methods: From March 2004 to January 2006, eleven patients (27-48 years, mean: 37 years) with UFE to treat symptomatic uterine myoma, were retrospectively reviewed. A serial follow up gray-scale and color Doppler US were performed from one day to two weeks following a UFE. The US findings were evaluated for the presence and distribution pattern of air, time of air loss, and presence of fluid collection in the uterine cavity and color Doppler (SD Comment: Doppler is name. Should perhaps be upper case) signal. Results: Numerous high echoes with reverberation artifacts (which suggest air), were observed within the myoma (in all cases), one day after UFE. A branching linear echo pattern was observed in 4 cases (36%), whereas scattered echoes were observed in 7 cases (64%). Progressive loss of air, within 7 days of a UFE, was observed in 9 cases (82%), whereas 2 cases (12%) were observed within 14 days of a UFE. Abnormal fluid collection in the uterine cavity and a color Doppler signal within the myoma was not observed for all cases. Conclusion: Branching or scattered echoes (suggesting air), are normally found within the myoma after a UFE, but these echoes disappeared within 2 weeks. These early US findings can be useful in differentiating from myoma infections after a UFE.

Purpose: To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). Materials and Methods: The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. Results: The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (p

Vascular tumors of the breast are uncommon and occur, for the most part, in the form of angiosarcomas. Benign breast hemangiomas are especially rare, with few reports existing in the literature. We report a case of a subcutaneous cavernous hemangioma of the breast and describe the sonographic, MRI findings and pathologic features.

Endovascular procedures are becoming the standard type of care for the management of hemodialysis vascular access dysfunction. As with any type of medical procedure, these techniques can result in procedure-related complications, although the expected number of complications is low. The clinical extent of these complications varies from case to case. Management of these cases depends on the clinical presentation. Major complications such as vein rupture, arterial embolism, remote site bleeding or hematoma, symptomatic pulmonary embolism and puncture site complications necessitating treatment require major therapy. Minor complications such as non-flow compromising small puncture site hematoma or pseudoaneurysms require little or no therapy. It is essential that the interventionist be prepared to manage these complications appropriately when they arise.

Prepancreatic postduodenal portal vein (PPPV) is a rare anomaly in which the portal vein runs between the pancreatic head and the duodenum. Understanding of this portal vein anomaly is important to avoid devastating complications, including portal vein ligation, resection or intraoperative hemorrhage. A 28-year-old female patient presented with right upper quadrant pain that she had suffered with for 2 days. Before performing laparoscopic cholecystectomy, we detected an abnormal shaped portal vein that ran in front of the pancreatic head and posterior to the duodenum on the CT scan. We report here on a rare case of prepancreatic postduodenal portal vein that was incidentally discovered on the CT axial images and coronally reformated images, in addition to observing it on the conventional portography.

Most giant sacral schwannomas are associated with moderate to massive bone destruction before they extend into the presacral space. These lesions can, on rare occasions, manifest as a giant tumor in the presacral space without bone destruction. We report here on the image findings of a presacral giant schwannoma in a 65-year-old man. On ultrasound and CT, the tumor appeared as an inhomogenous, well-demarcated mass that demonstrated some cystic changes and peripheral calcifications without sacral bone destruction. On the MR imaging, the tumor showed as an inhomogeneous, encapsulating mass with low signal intensity on both the T1 and T2-weighted images, except for some areas that showed cystic change.