Vascular System

This chapter discusses cases of vascular pathology with correlative nuclear and anatomic imaging. Areas covered include inflammation, infection, neoplasia, molecular receptor expression, and physiologic processes such as osteogenesis. Imaging of vasculitis includes ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and MRI angiography, conventional catheter angiography, and nuclear imaging. CT can rapidly distinguish conditions that mimic aortitis, such as aortic dissection, intramural hematoma, and penetrating aortic ulcer. CT provides information about structural changes, i.e. calcification caused by atherosclerosis which reflects the disease stage, as opposed to the positron emission tomography component of the study, which evaluates the active plaque inflammation. On CT, tumoral or nontumoral thrombosis can be differentiated if hypervascularity is shown in the tumor thrombus by use of intravenous contrast. On CT, aortoenteric fistulas may show peri-graft gas greater than 4 weeks after the surgery, aortic wall disruption, gas in the aortic lumen, and contrast extravasation into the bowel lumen or peri-aortic space.