Case Report 1. CTA head. (c) Tele3D Advantage, LLC
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1 Case Report 1 CTA head 1
2 History 82 YEAR OLD woman with signs and symptoms of increased intra cranial pressure in setting of SAH. CT Brain was performed followed by CT Angiography of head. 2
3 CT brain Extensive subarachnoid hemorrhage in the basal cisterns, fissures, and distributed throughout the sulci. Predominance of the hemorrhage is left sided. 3
4 3 Dimensional (3D) images PCom PCom Aneurysm Maximum Intensity Projection (MIPs) Bleed L PCOM Volume Rendering (VRs) Aneurysm 4
5 CTA head Posteriorly and superiorly directed multilobulated aneurysm arising at the left posterior communicating artery origin. The aneurysm has ruptured into the left insular lobe, and demonstrates a jet of contrast extravasating into the hematoma from the distal sac. Multiple small other intracranial aneurysms. 5
6 3 Dimensional (3D) images LPCOM Active bleed Aneurysm R PCOM Aneurysm L PCOM Aneurysm R PCOM Aneurysm Volume Rendered Images 6
7 Post Intervention CTA- Status post coiling of left posterior communicating artery aneurysm. Grossly unchanged appearance of multiple additional intracranial aneurysms. 7
8 3 Dimensional (3D) images Aneurysm coil MIPs Aneurysm coil VRs 8
9 Case Report 2 CTA neck 9
10 History 82 year woman status post left carotid endarterectomy presented with an enlarging mass in the left side of the neck. CT Angiography of the neck was advised after findings at Ultrasound Doppler of the neck. 10
11 3 Dimensional (3D) images Axial CTA image MIP and VR of LCCA pseudoaneurysm 11
12 3 Dimensional (3D) images Pseudoaneurysm with surrounding thrombus of the left common carotid artery/carotid bifurcation. VR with and without bone subtraction 12
13 Case Report 3 CTA neck 13
14 History 12 year old male with mixed connective tissue disease presented with 1day of headache with blurry vision. No diplopia 14
15 CT brain Stable ex vacuo dilatation of the temporal and occipital horns of the right lateral ventricle. 15
16 3 Dimensional (3D) images Curved Reformats Coronal and Sagittal RICA/RCCA 16
17 The right common carotid artery (RCCA) not identified. There is reconstitution of the right internal carotid artery (RICA) via collaterals. The right internal carotid artery is narrow in caliber into its intracranial segments, likely due to diminished flow. Rest of the cervical vessels normal. Intra cranial vessels were normal. 17
18 3 Dimensional (3D) images MIPS- RICA and RCCA 18
19 3 Dimensional (3D) images MIPS- RCCA 19
20 3 Dimensional (3D) image MIP Normal intra cranial vessels 20
21 3 Dimensional (3D) images MIPS- Normal LICA/ LCCA and posterior circulation 21
22 Case Report 4 CTA Stroke 22
23 History 49 year old with Left Middle Cerebral Artery (LMCA) distribution embolic strokes 23
24 3 Dimensional (3D) image MIP image LMCA- Apparently normal appearing branches 24
25 3 Dimensional (3D) images On close inspection Vessel cut off within distal left M2 branch with suggestion of partial p recanalization 25
26 Case Report 5 CTA Stroke 26
27 History 56 year woman with previous stenting of left carotid artery presented with fresh complaints of carotid stenosis 27
28 3 Dimensional (3D) images CTA study June 2004 Left common carotid artery graft with complete occlusion. Collateral flow to left internal carotid artery probably via the left external carotid artery. Curved Reformat LICA/ LCCA 28
29 3 Dimensional (3D) images MIPs demonstrating occluded LCCA stent 29
30 3 Dimensional (3D) images CTA study November 2008 (Patient presented with aphasia) Left common carotid artery graft with complete occlusion as before. New finding of thrombus extension into left internal carotid artery and a thrombus at the left MCA trifurcation. Curved Reformat LICA/LCCA (Graft) 30
31 3 Dimensional (3D) images MIPs demonstrating occluded LCCA stent and thrombus extension into LICA and thrombus in left MCA 31
32 Case Report 6 CTA Abdominal Aorta 32
33 History 84 year woman S/P endovascular graft repair of AAA. CTA performed to assess change in size of aneurysm and look for leak. 33
34 3 Dimensional (3D) images CTA study-november 2002 Status post infrarenal abdominal aortic endograft placement, with the proximal attachment at the infrarenal level and distal attachment at the level of the aortic bifurcation. No evidence of endoleak. VR Aortic Endograft and Aneurysm sac 34
35 3 Dimensional (3D) images CTA study-november 2004 There is a new proximal attachment type 1 endoleak. The aneurysm measures 5.4, compared to 4.5cm, previously. MIPs aortic endoleak VR aortic endoleak 35
36 Case Report 7 CTA Aorta 36
37 History 60 year woman with aortic dissection with interposition graft repair for follow-up. 37
38 3 Dimensional (3D) images Status post a Type I (A) dissection with interposition graft repair of the proximal ascending aorta. Dissection of the proximal ascending aorta begins at the pulmonary artery bifurcation and extends into the descending aorta, to the level of the aortic bifurcation. True lumen is smaller and located to the right of the false lumen MIP and VR of Aortic dissection 38
39 3 Dimensional (3D) images Dilatation of the aortic annulus - measures 5.6 cm in diameter. Arch vessels originate from true lumen. Celiac artery (CA) originates from the false lumen. 39
40 3 Dimensional (3D) images SMA The dissection extends into SMA. IMA originates from true lumen. Vessels are all patent. RRA Right renal artery (RRA)( originates from true lumen. Left renal artery (LRA)) originates from false lumen. LRA Bilateral common iliac arteries originate from true lumen. RRA SMA LRA 40
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