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1.  A 128-slice CT scanner helpful in localising coronary sinus ostium during CRT-D implantation – case report 
Summary
Background
Cardiac resynchronization therapy (CRT) has become a successful treatment option for symptomatic heart failure in patients with poor left ventricular (LV) systolic function and broad QRS complex in the surface electrocardiogram (ECG).
Case Report
In this report we present a case of a 70-year-old woman with advanced heart failure due to ischaemic heart disease who underwent an upgrade from VVIR stimulator (pacemaker, PM) to cardiac resynchronization therapy defibrillator (CRT-D). The first attempt was unsuccessful due to problems with inefficient cannulation of the orifice of the coronary sinus (CS). After performing a 3D reconstruction with a 128-slice CT scanner, it was possible to carry out the up-grade to CRT-D resulting in enormous clinical improvement.
Conclusions
The case represents an example of the usefulness of 3D reconstruction with the 128-slice CT scanner used after failed CRT-D implantation due to difficulties with efficient cannulation of the coronary sinus orifice in a rare anatomical variant.
doi:10.12659/PJR.889859
PMCID: PMC3913256  PMID: 24497895
cardiac resynchronization therapy; cardioverter-defibrilator (CRT-D); 128-slice CT scanner; coronary sinus
2.  Giant congenital malformation of the perirectal plexus in computed tomography imaging – case report 
Polish Journal of Radiology  2013;78(2):50-53.
Summary
Background:
Congenital arteriovenous malformation (AVM) in the pelvic area is uncommon in males.
Case Report:
The described case is of a giant lesion of this type that caused recurrent hemorrhaging in the lower part of the gastrointestinal tract. Preliminary diagnosis of vascular pathology was made on the basis of an endoscopic examination that revealed numerous pulsating protuberances of the rectal wall, in which blood flow was identified by means of transrectal ultrasonography. Complementing the diagnostics with a CT revealed a considerable extent of malformation, as well as its morphology and anatomical relations with the surrounding tissues.
Results:
Following a two-year follow-up period, the malformation did not progress or demonstrate any intensification of clinical symptoms, therefore the patient continues to undergo conservative treatment.
doi:10.12659/PJR.883945
PMCID: PMC3693837  PMID: 23807885
Pelvic arteriovenous malformation (pAVM); lower gastrointestinal tract bleeding; spiral computed tomography (CT); computed tomography angiography (angio-CT); 3D reconstructions
3.  Multiple fusiform cerebral aneurysms – case report 
Polish Journal of Radiology  2012;77(1):50-53.
Summary
Background:
A true aneurysym is a dilation of arterial lumen as a consequence of congenital or acquired abnormalities leading to a reduction of mechanical resistance of vascular wall, most commonly caused by its defected structure in the form of absence or weakening of the muscular and/or elastic layer. From the pathophysiological point of view, cerebral aneurysms can be classified as ‘saccular’ – most commonly occurring, and ‘other types’, including fusiform/dolichoectatic, dissecting, serpentine, posttraumatic, mycotic and giant aneurysms with or without intra-aneurysmal thrombosis.
Case Report:
We present a rare case of a patient with multiple fusiform dilations of cerebral vessels and giant fusiform aneurysm in supraclinoid segment of the internal carotid artery. The patient presented to hospital because of sudden, severe vertigo with nausea, impaired balance and disturbed vision. Vascular anomalies were detected on CT scanning without contrast. The diagnostic work-up was complemented by CT angiography, MRI and cerebral angiography.
Conclusions:
Aneurysm located within the intracranial arteries is one of the most common vascular defects of the brain. The number, size and location of aneurysms are highly variable. Aneurysms can have either supra- or infratentorial location, affecting a single or multiple arteries within one or both brain hemispheres. There is often a correlation between the location of the aneurysm and its etiology, as in case of so-called mirror-image aneurysms. Symmetrically located aneurysms may indicate a defect in vascular structure. Asymmetric location, as in the patient described above, is more likely due to acquired causes, mainly atherosclerosis, but also septic emboli or blood disorders.
PMCID: PMC3389952  PMID: 22802866
fusiform aneurysm; dolichoectasia; cerebral giant aneurysm; angio-CT; angiography; endovascular treatment
4.  A case of a spontaneous splenorenal shunt associated with the nutcracker syndrome 
Polish Journal of Radiology  2011;76(4):49-51.
Summary
Background:
Hypertension in the portal vein system stimulates the vascular system to develop a porto-caval collateral system, which occurs by adaptation of the already existing junctions between the porto-caval and the systemic circulation to changed conditions or by angiogenesis.
Case Report:
We present a case of a 42-year-old man with alcoholic cirrhosis of the liver and exacerbation of chronic pancreatitis, whose computed tomography of the abdominal cavity revealed a massive varicoid dilatation of a vein of the spleen with a splenorenal shunt and tortuous dilated venous vessels in the retroperitoneal space and mesentery.
Conclusions:
The unusual image of the mesenteric and retroperitoneal venous vessels in our patient resulted from the coexistence of collateral porto-systemic circulation and compression of the left renal vein.
PMCID: PMC3389944  PMID: 22802855
liver cirrhosis; portal hypertension; porto-caval collateral circulation; spontaneous splenorenal shunt; nutcracker syndrome; computed tomography (CT)

Results 1-4 (4)