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[Indocyanine green infrared fluorescence angiography and vascular cast--preparation in experimental choroidal circulatory disturbance].

We performed experiments in 20 monkey eyes in order to clarify basic problems about interpretation of indocyanine green fluorescence angiography (ICG angiography). We severed the temporal group of posterior ciliary arteries to produce choroidal circulatory disturbance. ICG angiography was performed immediately, and 2 days, 4 days, and 2 weeks later. Following each ICG angiography, the eye was studied by plastic vascular cast technique with scanning electron microscopy. Immediately after occlusion, ICG angiography showed filling defect in the temporal choroidal hemisphere during the early phase. In the later phase, this area was gradually filled by the dye from choroidal arteries in the nasal hemisphere and the anterior ciliary arteries. Vascular cast preparations showed filling defect in the temporal choroidal hemisphere, corresponding with the early ICG angiogaphic findings. Both filling delay in ICG angiography and filling defect in vascular casts improved daily after occlusion. Two weeks after occlusion, The area of choroidal infarct temporal to the macula turned into chorioretinal atrophy. This area showed hypofluorescence in the early-phase ICG angiography and filling defect of the choriocapillaris in plastic casts. The early-phase ICG angiographic findings thus corresponded well with observations of vascular casts. We conclude that ICG angiography correctly reflects the actual circulatory disturbances in the choroid.

Animals↗

[Indocyanine green infrared fluorescence angiography and histopathological correlation in experimental choroidal circulatory disturbance. Report 1].

We performed an experimental study on choroidal circulatory disturbance to clarify basic problems about interpretation of retino-choroidal lesions in indocyanine green fluorescence angiography (ICG angiography). We severed all of the posterior temporal ciliary arteries, to produce choroidal circulatory disturbance. Fluorescein angiography and ICG angiography were performed using scanning laser ophthalmoscope immediately, and 2 days after occlusion. These findings were compared with histopathological findings from the same specimen. Immediately after occlusion, choroidal vessels were filled with the red blood cells in the lesion that showed hypofluorescence in both types of angiography. Two days after occlusion, the fundus had a grayish white edematous appearance which was similar to choroidal infarction. The retinal pigment epithelial cells. (RPEs) in infarcted lesion progressed to liquefied necrosis. Fluorescein angiography showed hyperfluorescence in the lesion, and ICG angiography showed hypofluorescence in the early phase, but hyperfluorescence at the margin of the lesion in the late phase. This result showed that damaged RPEs were stained by ICG dye. In reading ICG angiography, we have to consider that the ICG angiogram is greatly modified by the condition of the RPEs.

Animals↗

[Indocyanine green angiography in Stargardt's disease].

We performed indocyanine green angiography (ICG angiography) and fluorescein angiography in order to investigate the choroidal circulation in patients with Stargardt's flavimaculatus. Eight eyes of 4 patients in Groups 2 approximately 3 (Noble classification) were included in this study. In the area with "dark choroid" in fluorescein angiography, ICG angiography revealed large choroidal vessels in all eyes, but some fluorescent choroidal vessels were dark around the atrophic macula and in the peripapillary area, which indicated a greater storage of lipofuscin within the retinal pigment epithelium in those areas. In the atrophic macula area, irregular hypofluorescence was observed in ICG angiography, which might be caused by filling defect and/or block. Many flecks revealed hyperfluorescence in fluorescein angiography and hypofluorescence in ICG angiography, suggesting that focal circulatory disturbances in the choriocapillaries exist beneath the flecks.

Adolescent↗

Three-dimensional contrast-enhanced MR angiography.

Three-dimensional contrast-enhanced magnetic resonance (MR) angiography is a relatively new technique that uses the transient shortening in blood T1 following the intravenous injection of gadolinium chelates to image blood vessels irrespective of flow. For many applications, 3D contrast-enhanced MR angiography is developing into a safe, fast, and cost-effective alternative to conventional diagnostic angiography. One of its biggest advantages over other MR angiography techniques (and CT angiography) is the ability to image in a plane parallel to the vessel of interest. This feature, combined with the inherent properties of a 3D gradient refocused sequence, make 3D contrast-enhanced MR angiography intrinsically fast, high resolution and free from saturation and turbulence-related artifacts. This article is designed to familiarize the reader with the theory of 3D contrast-enhanced MR angiography and the application of the technique to different vascular territories. Contrast agents, relaxation effects, contrast bolus effects, pulse sequences, artifacts, and post-processing, as well as the present state of thinking with regard to optimal contrast injection timing/detection and Fourier space mapping are discussed. Patient preparation and techniques and imaging parameters for body applications of gadolinium-enhanced MR angiography, including aorta, renal arteries, mesenteric arteries, portal venous system, pelvis and legs, pulmonary arteries, and carotid arteries are included.

Fourier Analysis↗

[Magnetic resonance angiography of coronary arteries: assessment in patients with coronary stenosis and control after stent positioning].

INTRODUCTION: Cardiovascular disease remains the leading cause of death in the world. Invasive coronary angiography is currently the only clinical method available to visualize the coronary arteries, with up to 20% of the procedures demonstrating no evidence of severe coronary artery stenoses. We investigated the role of two-dimensional (2D) coronary magnetic resonance angiography (MRA) in patients with suspected coronary arteries disease and to check the placement and the patency of previously placed coronary artery stents. MATERIAL AND METHODS: Eleven patients with suspected coronary artery disease who underwent elective cardiac catheterization with coronary angiography were examined with 2D coronary MRA to detect coronary artery stenoses. Other 11 patients with 13 stented coronary arteries (6 RCA, 5 LAD, 2 Lcx) were prospectively examined with MRA one day to 8 months after stent placement. Eighteen amagnetic stents were imaged. Imaging was performed with a 1.5 T MR unit (GE Signa Horizon Echo Speed) with a phased array multicoil. Segmented k-space fast GE sequences were acquired with and without fat suppression at several cardiac cycle phases within a single breath-hold. Correlation with coronary angiography was performed in all patients. RESULTS: Thirteen significant stenoses were found at coronary angiography in 11 coronary arteries. The sensitivity and specificity of MR coronary angiography, as compared with conventional angiography, in correctly identifying the single vessels with > 50% angiographic stenoses were 73% and 94%, respectively. The corresponding positive and negative predictive values and accuracy were 88%; 84% and 86%, respectively. As far as the study of coronary artery stents is concerned, no MR-related adverse events were observed. The stents were visualized as signal loss areas. The length of the signal loss corresponded to the length of the stents in all 18 cases (r = 97). The patent blood flow distal to the stents appeared as a high-signal band distal to the signal void, corresponding to stent patency at coronary angiography. CONCLUSIONS: Although in an early stage of technical development, 2D coronary MRA can depict 73% of hemodynamically severe coronary artery stenoses. Moreover breath-hold coronary cine MRA is a safe technique to visualize coronary artery stents. Stent site and patency can be noninvasively studied with this technique.

Adult↗

Assessing coronary artery disease in women: how useful is coronary angiography?

The data are conflicting, but the suspicion is that there may be a gender bias against referring women for angiography in coronary disease evaluation. These cardiologists, however, review the studies and conclude that, even with the available noninvasive tests, coronary angiography continues to be the gold standard for assessing and monitoring heart disease -- even in women. The burden of coronary artery disease (CAD) in women is significant. In spite of increasing uses of noninvasive testing, coronary angiography remains the gold standard in the diagnosis and assessment of CAD. Since gender differences exist in the clinical presentation of CAD and in the sensitivity and specificity of noninvasive testing, coronary angiography remains an invaluable tool in providing diagnostic and prognostic information in women. Angiography is also appropriate when vasospastic disease is suspected. Although gender differences in the indication for coronary angiography are recognized, evidence as to whether there is a bias against women in the referral for cardiac catheterization after noninvasive testing or myocardial infarction is conflicting. The possibility that physicians underestimate the risk of disease in women cannot be ruled out. Therefore, proper training of physicians in the clinical assessment and prediction of the pretest risk for coronary disease in women cannot be overemphasized. In addition, physicians should be aware that normal coronary angiograms in women cannot always rule out the existence of myocardial ischemia, especially in conditions such as variant angina and syndrome X. Coronary angiography has also been invaluable in elucidating the benefits of lipid-lowering therapy and estrogen use in women in the prevention of heart disease. Coronary angiography, therefore, remains an invaluable tool in the management of CAD in women.

Adult↗

Contrast-enhanced three-dimensional fast imaging with steady-state precession (FISP) MR angiography of supraaortic vessels: preliminary results.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the effectiveness of contrast-enhanced fast three-dimensional (3D) MR angiography in depicting both the carotid and vertebral arteries in their cervical portions and to compare MR angiography with conventional angiography for the evaluation of arteriosclerotic disease. METHODS: Twenty-seven patients with ischemic cerebral events in the anterior (n = 18) and posterior (n = 9) circulation underwent contrast-enhanced 3D MR angiography in the coronal plane. MR angiograms were examined in a blinded fashion by two observers independently. Stenosis was classified according to the appearance of the residual lumen (no stenosis, mild stenosis, moderate stenosis, severe stenosis, occlusion). Conventional angiography was used as the standard of reference. RESULTS: Proximal great vessels and carotid siphons were not assessable on MR angiograms in 35% of cases owing to limited coverage. All cervical and petrous segments of the internal carotid arteries (ICAs) and 93% of the extracranial vertebral arteries were assessable. Flow-related artifacts were observed in seven cases of severe stenosis, including three with signal void at the site of narrowing and four with signal loss in the distal ICA. Interobserver agreement was good and significant. Overall agreement between 3D MR angiography and conventional angiography was good for the anterior and posterior circulations despite a tendency toward overestimation of stenoses on MR angiograms. Clinically relevant stenoses and occlusions were correctly identified on 3D MR angiograms, providing good sensitivity and specificity. CONCLUSION: Contrast-enhanced 3D MR angiography is a promising tool for assessing arteriosclerotic lesions of supraaortic vessels. Further studies with larger groups are required to determine its value for patient care.

Adult↗

[2-D-time-of-flight MR angiography of the peripheral blood vessels. Experimental and clinical studies on value of this method in arterial occlusive diseases].

PURPOSE: A retrospective study was performed in 70 patients with peripheral vascular disease who underwent MR angiography of the lower extremity. MATERIAL AND METHODS: MR angiography was performed with a 2-D-TOF sequence including a travelling presaturation to suppress the venous signal. Postprocessing images were obtained with the MIP algorithm. The MRA results were compared with conventional or digital angiography in all patients. RESULTS: Only 19 stenoses out of 31 which showed a degree of stenosis between 30 and 99% could be visualised by MR angiography. 9 stenoses were correctly classified by MRA. In 9 cases the degree of stenosis was overestimated, in one case it was underestimated. All 56 occlusions were correctly detected. 12 severe stenoses diagnosed with conventional angiography were graded as occlusions with MR angiography. CONCLUSIONS: MR angiography cannot be accepted in preoperative staging of patients with peripheral vascular disease. The postoperative examination seems to be a practical noninvasive alternative.

Algorithms↗

Three-dimensional computed tomographic angiography of cerebral aneurysms.

We describe our technique and results of dynamic, reconstructed, three-dimensional (3-D) computed tomographic (CT) angiography in our first 18 patients with either complex aneurysms, producing subarachnoid hemorrhage or the compression of neighboring structures, or small asymptomatic aneurysms, and assess the role of this technique in treatment planning. A dynamic, infused CT scan producing 1.5-mm cuts of the area of interest was performed, and the two-dimensional images were reconstructed in three dimensions with the ISG Allegro system (ISG Technologies, Toronto, Ontario, Canada). Results were compared with intra-arterial digital subtraction angiography and magnetic resonance angiography. All aneurysms over 3 mm and half of the aneurysms less than or equal to 3 mm were demonstrated by 3-D CT angiography. The neck of the aneurysm, its relationship to the parent artery and associated branches, and its relationship to surrounding bony structures, such as the anterior clinoid, were also demonstrated. This was especially useful for ophthalmic aneurysms. The 3-D image could be rotated on the screen to mimic the operative approach. The active, filling portion and the thrombosed part of partially thrombosed, giant aneurysms could be seen on the same image, and the active, filling portion could be better appreciated with 3-D CT angiography than with magnetic resonance angiography. A partially treated, acrylic-coated aneurysm that could not be completely assessed otherwise has been demonstrated by this technique. 3-D CT angiography is useful in the evaluation of aneurysms, especially when the local anatomy is obscured or distorted by its mass or by the anterior clinoid.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Diagnostic angiography using multi-slice spiral CT in acute obstruction of the basilar artery].

OBJECTIVE: To evaluate the diagnostic efficiency of CT angiography in case of clinical signs of acute brainstem infarction for the therapeutic management of catheter-based local thrombolysis. MATERIAL AND METHODS: 3 patients (2 males, 1 female) suffering from an acute onset of brainstem symptoms and being suspicious of an occluded basilar artery were included into this report. 1 patient underwent selective vertebral arteriography. 2 patients were initially examined with CT angiography using a 4-row scanner and 100 ml intravenous contrast agent. RESULTS: In one patient, an occlusion of the basilar artery was excluded with catheter-based angiography. Subsequently, the patient was treated with systemic thrombolysis using r-tPA because of a thalamus infarction seen in MRI. 2 patients who have been initially examined with CT angiography presented with complete occlusions of the basilar arteries. These patients underwent r-tPA thrombolysis by means of superselective micro-catheter approaches of the vertebrobasilar vessels. CT angiography was very useful for determinating the occlusion length of the basilar artery pre-therapeutically, and in 1 case for ruling out an occluded vertrebral artery for catheterization. All patients recovered well under thrombolytic therapy applied systemically or selectively. CONCLUSION: Cerebral multi-slice CT angiography is a fast and save technique for detecting or ruling out an acute basilar artery occlusion. Thus, in cases of equivocal clinical signs CT angiography is recommended before the decision of thrombolytic therapy is made.

Adult↗

Diagnosis of intracranial aneurysms: accuracy of MR angiography at 0.5 T.

PURPOSE: Our goal was to determine the accuracy of MR angiography at 0.5 T for the diagnosis of intracranial aneurysms. METHODS: We retrospectively studied 140 patients, 70 with acute subarachnoid hemorrhage, who were either at high or low risk for intracranial aneurysm. Three-dimensional time-of-flight MR angiography was typically performed to cover the circle of Willis, with a volume thickness of 30 mm. Conventional spin-echo MR images and MR angiograms were reviewed together, and the results were compared with those obtained at intraarterial cerebral angiography to determine the sensitivity and specificity of MR angiography. RESULTS: Eighty-nine aneurysms (size range, 2 to 27 mm; 25 aneurysms < 5 mm) were identified at intraarterial cerebral angiography. Six aneurysms were missed by MR angiography and two were doubtful (sensitivity, 91% to 93%; specificity, 100%). Missed aneurysms were located outside the MR angiographic acquisition volume (n = 3) or on the carotid siphon (n = 3; size = 2, 3, and 5 mm). CONCLUSION: Even if MR angiography presents some restrictions in acquisition volume and spatial resolution, the detection rate of intracranial aneurysms is excellent at 0.5 T in both asymptomatic patients and in those with subarachnoid hemorrhage. A midfield system is not a restriction to the detection of intracranial aneurysms by MR examination.

Adolescent↗

Spatio-temporal filtering of digital angiography image data.

As welfare diseases become more common all over the world the demand for angiography examinations is increasing rapidly. The development of advanced medical signal processing methods has with few exceptions been concentrated towards CT and MR while traditional contrast based radiology depend on methods developed for ancient photography techniques despite the fact that angiography sequences are generally recorded in digital form. This article presents a new approach for processing of angiography sequences based on advanced image processing methods. The developed algorithm automatically processes angiography sequences containing motion artifacts that cannot be processed by conventional methods like digital subtraction angiography (DSA) and pixel shift due to non uniform motions. The algorithm can in simple terms be described as an ideal pixelshift filter carrying out shifts of different directions and magnitude according to the local motions in the image. In difference to conventional methods it is fully automatic, no mask image needs to be defined and the manual pixelshift operations, which are extremely time consuming, are eliminated. The algorithm is efficient and robust and is designed to run on standard hardware of a powerful workstation which excludes the need for expensive dedicated angiography platforms. Since there is no need to make additional recordings if the patient moves, the patient is exposed to less amount of radiation and contrast fluid. The most exciting benefits by this method are, however, that it opens up new areas for contrast based angiography that are not possible to process with conventional methods e.g. nonuniform motions and multiple layers of moving tissue. Advanced image processing methods provide significantly better image quality and noise suppression but do also provide the means to compute flow velocity and visualize the flow dynamics in the arterial trees by e.g. using color. Initial tests have proven that it is possible to discriminate capillary blood flow from angiography data which opens up interesting possibilities for estimating the blood flow in the heart muscle without use of nuclear methods.

Algorithms↗

Diagnosis of pulmonary arteriovenous malformations by colour Doppler ultrasound and amplitude ultrasound angiography.

BACKGROUND: The clinical value of colour Doppler ultrasound and amplitude ultrasound angiography in the diagnosis and follow up of pulmonary arteriovenous malformations (PAVM) was investigated. METHODS: Six consecutive patients suspected by clinical appearance and abnormal chest radiographic findings of having PAVM were included in the study. Ultrasonography was performed first by real time grey scale imaging then by colour Doppler imaging and amplitude ultrasound angiography in a random order. All were later proved by angiography to have PAVM. RESULTS: The ultrasound study was successfully performed in all six patients. A total of eight lesions was detected. The real time grey scale image of PAVM revealed well defined hypoechoic subpleural nodules with strong posterior acoustic enhancement. Colour Doppler ultrasound of PAVM showed turbulent flow, manifest as an area of intense colour with high and mixed velocities (reticulated or mosaiclike pattern). Anatomical continuity was demonstrated in some PAVM. Amplitude ultrasound angiography can delineate a tangled vascular structure with a clear vessel wall and anatomical continuity as well as conventional angiography. Spectral wave analysis showed a relatively low impedance flow presenting with high peak systolic velocity (mean 44.4 cm/s) and relatively high diastolic velocity (mean 19.3 cm/s). The mean pulsatility index (PI) and resistive index (RI) were 1.80 and 0.49, respectively. In two patients who received embolotherapy the colour Doppler ultrasound scan obtained after the procedure showed that the previous focal areas of colour flow signals disappeared or diminished in size. This was compatible with the decrease in, or absence of, blood flow demonstrated by angiography after embolotherapy. CONCLUSIONS: Combined colour Doppler ultrasound and amplitude ultrasound angiography are useful non-invasive techniques for diagnosis PAVM and provide an alternative approach to angiography in evaluating the efficacy of embolotherapy.

Adolescent↗

MR angiography of the portal and hepatic venous systems: preliminary experience with echoplanar imaging.

OBJECTIVE: The purpose of this study was to evaluate the ability of echoplanar MR angiography to depict the major hepatic and portal venous structures. SUBJECTS AND METHODS: Echoplanar and conventional MR angiographic examinations were performed in 10 subjects (seven healthy volunteers, three patients with focal hepatic lesions). A gradient-recalled echo (GRE) time-of-flight technique (125/10 [TR/TE], 90 degrees flip angle) was used for echoplanar angiography. Eight complete single-excitation images were acquired at each level in 1.5 sec and then collapsed into a single maximal intensity projection. Conventional time-of-flight MR angiography (34/13, 30 degrees flip angle) also was performed. The vascular anatomy from the right atrium to the splenic vein was imaged (6-mm contiguous levels) in three 10.5-sec breath-holds with echoplanar imaging, as compared with seven 11.5-sec breath-holds with conventional MR angiography. Echoplanar and conventional images were compared quantitatively and qualitatively. RESULTS: Echoplanar imaging was 61% faster than conventional MR angiography. Vessel-to-liver signal-intensity ratios were significantly higher for echoplanar imaging (p < .0001), signal-to-noise ratios were significantly higher for conventional MR angiography (p < .0001), and contrast-to-noise ratios were comparable. Qualitatively, echoplanar imaging and conventional MR angiography provided similar anatomic information about the hepatic and portal veins. CONCLUSION: Angiograms of the hepatic and portal venous systems that are of diagnostic quality can be acquired much more quickly with echoplanar imaging than with conventional MR angiography.

Echo-Planar Imaging↗

The use of helical CT and CT angiography to predict vascular involvement from pancreatic cancer: correlation with findings at surgery.

OBJECTIVE: The purpose of this study was to test the accuracy of helical CT with and without CT angiography to predict vascular involvement from pancreatic cancer and correlate the resultant images with findings at surgery. SUBJECTS AND METHODS: Helical CT and CT angiography was done in 84 patients who had adenocarcinoma of the pancreas to refine an integrated CT angiography protocol. Of these patients 38 underwent radical pancreatoduodenectomy. Vessel integrity of the superior mesenteric artery, superior mesenteric vein, and portal vein was assessed prospectively on both axial CT scans and CT angiograms and correlated with findings at surgery and in particular with the ability of the surgeon to dissect the tumor from these vessels along the vascular planes. RESULTS: CT angiograms were obtained in 82 (98%) of 84 studies. Of the 38 patients who underwent radical pancreatoduodenectomy, resection was aborted in 11 (29%) because of vascular encasement, Compared with axial CT images, CT angiography was more accurate at revealing unresectable cases. In all but one of 11 patients with vessel encasement (narrowing of the lumen) revealed on CT angiography, the lesion was unresectable. Vessel encasement was shown in only two of these 11 patients on axial CT images (of these two patients, one underwent tumor resection). The negative predictive value of a resectable tumor was 96% for CT angiography and axial helical CT compared with 70% for axial helical CT images alone (p = .021). CONCLUSION: Helical CT with CT angiography of the pancreas provides useful information about local vascular involvement from pancreatic carcinoma. Compared with conventional axial helical CT, the addition of CT angiography improves radiologists' ability to predict the resectability of pancreatic tumors.

Adenocarcinoma↗

Technologic advances in magnetic resonance angiography.

Magnetic resonance angiography continues to develop both in technical capabilities and in clinical applications. Head and neck MR angiography is now in common use and is being compared to digital subtraction angiography (DSA) on a daily basis. New approaches to MR angiography in the abdomen and thorax and peripheral areas are making progress. Even coronary angiography is likely to fall prey to MR angiography and the prowess of those designing new techniques. The role of contrast agents in MR angiography is becoming more evident; contrast agents are likely to play an important role in the future. Furthermore, quantitative flow velocity measurements of major vessels are also possible and are of interest to clinicians for blood flow information. This review covers these and other recent developments in MR angiography, including both technical and clinical developments.

Blood Flow Velocity↗

Pulmonary MR angiography: a comparison of 2D and 3D time-of-flight.

OBJECTIVE: To compare two-dimensional (2D) time-of-flight (TOF) MR angiography and three-dimensional (3D) TOF MR angiography for visualization of pulmonary arteries and to determine whether pulmonary veins can be viewed selectively. MATERIALS AND METHODS: Imaging was performed using a 1.5 T superconducting MR system with a body coil. Three kinds of 2D TOF MR angiography were compared in four normal volunteers: using a 2D fast low angle shot (FLASH) without cardiac gating and both with and without breath-holding and using a T2-weighted TurboFLASH with cardiac gating and breath-holding. Two-dimensional TOF MR angiography using a T2-weighted TurboFLASH with cardiac gating and breath-holding and 3D TOF MR angiography using fast imaging with steady precession with neither cardiac gating nor breath-holding were compared in four other normal volunteers. Two-dimensional TOF MR venography with a presaturation pulse to suppress artery signals was evaluated in another four normal volunteers. RESULTS: Three-dimensional TOF MR angiography appeared to be better than 2D TOF MR angiography for delineating pulmonary arteries in the volunteers. The third order branches of peripheral pulmonary veins were distinguishable on 2D TOF MR venography using a presaturation pulse. CONCLUSION: Three-dimensional pulmonary TOF MR angiography is useful in demonstrating pulmonary arteries whereas 2D TOF MR venography with a presaturation pulse is useful in showing pulmonary veins.

Adult↗

Differential diagnosis of renal lesions with US-angiography using intra-arterial CO2 microbubbles.

To differentiate renal masses, 58 patients with renal masses (39 men and 19 women, aged 23-81 years [mean age 60 years]) underwent US-angiography with intra-arterial infusion of carbon dioxide (CO2) microbubbles during conventional angiography; 32 patients had renal cell carcinomas; nine, transitional cell carcinomas; nine, renal complicated cysts; four, angiomyolipomas; two, acute focal bacterial nephritis and hematomas. Renal masses were classified into six enhancement patterns of US-angiography. Thirty-one (97%) renal cell carcinomas were histologically alveolar type and demonstrated the well-enhancement pattern. All nine renal complicated cysts showed the non-enhancement pattern. Although transitional cell carcinomas did not show definite neovascularity on conventional angiography, they were classified as the well-enhancement pattern in 4/9 (44%) and poor-enhancement pattern in 5/9 (56%) on US-angiography. Four angiomyolipomas were homogeneously enhanced. Complicated cysts were clearly differentiated from renal cell carcinomas by the enhancement pattern on US-angiography. But the differentiation between renal cell carcinomas and angiomyolipomas was difficult. US-angiography is useful for detecting fine neovascularity of renal lesions and also for the differentiation or renal cell carcinomas from complicated cysts or transitional cell carcinomas during conventional angiography.

Angiomyolipoma↗