Author/Editor		Pavčec, Zlatko; Žokalj, Ivan; Saghir, Hussein; Pal, Andrej; Roić, Goran
Title		Doppler ultrasound in the diagnosis and follow-up of the muscle rupture and an arteriovenous fistula of the thigh in 12 year boy
Translated title		Uporaba dopplerskega ultrazvoka pri ugotavljanju in sledenju mišične rupture in arteiovenozne fistule na stegnu 12-letnega dečka
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 40, št. 4
Publication year		2006
Volume		str. 211-5
Language		eng
Abstract		Background. With this case report the authors wish to present the accuracy of non-invasive vascular imaging methods, especially Doppler ultrasound, in the evaluation of the muscular trauma and periskeletal soft tissue vascular anomalies. Case report. Twelve year-old boy has been admitted with the right femoral quadriceps muscle traumatic rupture. Postoperative B-mod sonography (US) visualised recidivuous haematoma and Power Doppler depicted hypervascularized area, suspected vascular malformation (angioma). Doppler findings obtained on the right thigh vasculature gave us reasons to think about postčraumatic arteriovenous fistula. Doppler has been repeated in the specialized paediatric institution wičk the same results. Digital subtraction angiography, 8 months after trauma, did not confirm suspicions reported in US findings. Spiral computed tomagraphic angiography (CTA) performed 11 months after trauma clearly depicted a lesion which had been repeatedly described in US findings. Fourteen months after trauma the vascular surgeon performed the deep femoral artery muscular branches ligation, but in the official report only arteriovenous fistula was mentioned. After the surgery the patient was clinically better. The aetiology of the right femoral arteriovenous fistula and hypervascularized structure remains unclear. Conclusions. Every inadequately behaving recidivous posttraumatic haematoma should be evaluated with Doppler ultrasound. CTA can be performed if it is needed to clarify US findings.
Summary		Izhodišča. V članku avtorji na kliničnem primeru prikazujejo natančnost neinvazivnih slikovnih metod, zlasti Dopplerskega ultrazvoka pri ocenjevanju mišične poškodbe in obskeletnih žilnih nepravilnostih v mehkih tkivih. Prikaz primera. Obravnavali so 12-letnega dečka s poškodbo desne štiriglave stegenjske mišice, kjer je nasta mišična ruptura. Po operaciji so z običajnim 2-dimenzionalnim ultrazvokom videli ponavljajoči hematom. Z ultrazvočno preiskavo so pravtako ugotovili hipervaskularizirano področje in posumili na žilno nepravilnost (angiom). Ko so prekrvavljenost bolnikovega stegna pregledali z Dopplerskim ultrazvokom, so menili, da ima lahko bolnik arterijovenozno fistulo, ki je nastala po poškodbi. Podobnega mnenja so bili preiskovalci v pediatrični bolnici, kjer so dečka ponovno pregledali z Dopplerskim ultrazvokom. Vendar digitalna subtrakcijska angiografija, ki so jo naredili 8 mesecev po poškodbi, ni potrdila izvidov ultrazvočnih preiskav. Zato so 11 mesecev po poškodbi naredili računalniško tomografsko angiografijo, ki je jasno pokazala spremembe, ki so bile že večkrat opisane ob predhodnih ultrazvočnih preiskavah. 14 mesecev po poškodbi je bolnika operiral žilni kirurg in lclinično stanje se je znatno popravilo. Kljub preiskavam in kirurškemu posegu vzrok nastanka fistule pri dečku ni popolnoma pojasnjen. Zaključki. Ob neobičajnih ponavljajočih hematomih, ki nastanejo po poškodbi, je indicirana Dopplerska ultrazvočna priskava. Z računalniško tomografsko angiografijo laho natančneje opredelimo ultrazvočno vidne spremembe.
Descriptors		ARTERIOVENOUS FISTULA MUSCLE, SKELETAL RUPTURE HEMATOMA FEMORAL ARTERY CHILD FEMORAL VEIN ANGIOGRAPHY, DIGITAL SUBTRACTION