Active intrahepatic gadolinium extravasation following TIPS |
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| Institution: | 1. Department of Radiology, Hamamatsu Medical Center, Hamamatsu, Japan;2. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming 650093, PR China;2. State Key Laboratory of Complex Nonferrous Metal Resources Clean Utilization, Kunming University of Science and Technology, Kunming 650093, PR China;3. Faculty of Science, Kunming University of Science and Technology, Kunming 650093, PR China;4. The City University of Hong Kong Shenzhen Research Institute, Shenzhen 518000, PR China;1. Department of Radiology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey;2. Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey;3. Department of Psychiatry, Medical Faculty, Ataturk University, Erzurum, Turkey;1. Department of Interventional Radiology, Jackson Memorial Hospital/University of Miami Hospital, 1611 Northwest 12th Avenue, Miami, FL 33136, USA;2. MS3, University of Miami Hospital school of medicine, Miami, FL, USA;3. Department of Radiology, Jackson Memorial Hospital/University of Miami Hospital, Miami, FL, USA |
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| Abstract: | A 31-year-old male patient had a transjugular intrahepatic portal systemic shunt (TIPS) placed for acute Budd-Chiari syndrome secondary to paroxysmal nocturnal hemoglobinuria (PNH). Post-procedure, he was anticoagulated for his underlying paroxysmal nocturnal hemoglobinuria. After 11 days, he complained of upper abdominal pain and underwent magnetic resonance imaging (MRI). On immediate post-gadolinium spoiled-gradient-echo (SGE) images, active extravasation of gadolinium was depicted in one of two intrahepatic hematomas. Progression of layering of high signal gadolinium was shown from early to later phase post-gadolinium images. The active arterial bleeding was confirmed by conventional angiography performed immediately following the magnetic resonance imaging. |
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