Pseudoaneurysma der Arteria cystica

Cystic artery
pseudoaneurysm presenting as haematemesis. Hyperdensity in gall bladder suggestive of haemobilia.
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Cystic artery
pseudoaneurysm presenting as haematemesis. Round, well-defined, intensely enhancing lesion in gall bladder with enhancement similar to the aorta, suggestive of pseudoaneurysm. Note pericholecystic inflammatory changes and air foci in GB (due to cholecystoduodenal fistula).
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Cystic artery
pseudoaneurysm presenting as haematemesis. Intensely enhancing lesion in gall bladder - the pseudoaneurysm is clearly seen arising from the cystic artery.
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Cystic artery
pseudoaneurysm presenting as haematemesis. Cystic artery pseudoaneurysm - Clearly demonstrated on VR adjacent to right hepatic artery.
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Cystic artery
pseudoaneurysm presenting as haematemesis. Enhancing lesion in gall bladder parallels arterial enhancement in the delayed phase.
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Cystic artery
pseudoaneurysm presenting as haematemesis. Vascular lesion with colour flow in gallbladder. Gallbladder is thick-walled and shows internal echoes.
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Unruptured
pseudoaneurysm of the cystic artery complicating acute calculous cholecystitis. Contrast-enhanced abdominal CT revealing a nodular lesion nearby the gallbladder enhanced in the same manner as the aorta
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Unruptured
pseudoaneurysm of the cystic artery complicating acute calculous cholecystitis. Coronal contrast-enhanced abdominal CT with MIP reconstruction showing the pseudoaneurysm arising from a branch of the right hepatic artery (Arrow)
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Pseudoaneurysma der Arteria cystica

Aneurysma spurium Radiopaedia • CC-by-nc-sa 3.0 • de

False aneurysms, also known as pseudoaneurysms, are abnormal outpouchings or dilatation of arteries which are bounded only by the tunica adventitia, the outermost layer of the arterial wall. These are distinguished from true aneurysms, which are bounded by all three layers of the arterial wall. Pseudoaneurysms typically occur when there is a breach in the vessel wall such that blood leaks through the inner wall but is contained by the adventitia or surrounding perivascular soft tissue.

Pathology

Etiology
Location

They can involve any arterial segment or even a cardiac chamber. Examples include

Radiographic features

Some of the imaging features may be dependent on location.

Ultrasound

Due to the turbulent forward and backward flow, a characteristic yin-yang sign may be seen on color flow while a "to and fro" pattern may be seen with pulsed Doppler.

CT
  • hypoattenuating (non-contrast) or hyperattenuating (contrast-enhanced) smooth-walled sac adjacent to an artery, usually with a communication

Treatment and prognosis

The risk of rupture is higher than that of a true aneurysm of comparable size due to poor support of the aneurysm wall and thus false aneurysms generally require treatment.

Siehe auch:
Assoziationen und Differentialdiagnosen zu Pseudoaneurysma der Arteria cystica:
Cholezystoduodenale
Fistel
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