eMedicine Specialties > Radiology > Vascular/Interventional
Fibromuscular Dysplasia (Visceral Arteries): Multimedia
Updated: May 28, 2008
Multimedia
 | Media file 1: Distribution of various types of fibromuscular dysplasia. |
 | Media file 2: Three-dimensional gadolinium-enhanced magnetic resonance angiograms (MRAs) show medial fibroplasia, which appears as classic string-of-beads sign. This sign is due to multiple stenoses with intervening outpouchings that form a chain. In this case, the lesions involve the main right renal artery and the right accessory renal artery in a 37-year-old man with difficult-to-control hypertension. |
 | Media file 3: Conventional flush aortogram in a 47-year-old woman with difficult-to-control hypertension shows the characteristic string-of-beads sign of the right renal artery due to medial fibroplasia. |
 | Media file 4: Conventional flush aortogram in a 43-year-old woman with difficult-to-control hypertension shows focal stenosis of the left mid renal artery; this finding may represent intimal fibroplasia. |
 | Media file 5: Fibromuscular dysplasia in a 36-year-old woman with difficult-to-control hypertension. Delayed nephrogram phase of a flush aortogram shows a substantially reduced right kidney. |
 | Media file 6: This 32-year-old man had fibromuscular dysplasia involving many arteries, including 1 renal, the carotid, the vertebral, right brachiocephalic, the right subclavian, and several intracranial arteries. He had severe renovascular hypertension and initially presented with a pulsatile mass in the right supraclavicular fossa. His hypertension responded to renal angioplasty. The aneurysm in the right subclavian artery was resected. Histologic examination of the resected specimen confirmed medial fibroplasia. The extent of the patient's intracranial disease precluded further surgery. |
 | Media file 7: This 52-year-old man presented with pain in the left upper quadrant and was found to have a 3.2-cm aneurysm of the distal splenic artery. During surgery, the aneurysm ruptured, and splenectomy was performed. Histology of the resected splenic artery revealed intimal fibroplasia. Routine 2-year follow-up showed an enlarging aneurysm of the hepatic artery. Contrast-enhanced axial CT images show several narrowings of the common and proper hepatic arteries with intervening aneurysmal dilatation. Note the circumferential, lobulated tissue that is thickening outside the intima. This was assumed to be a manifestation of intimal fibroplasia. |
 | Media file 8: Coronal reconstructions of CT images in the same patient as in Image 7 in Multimedia. |
 | Media file 9: A 28-year-old man presented with episodic, postprandial abdominal pain, hypertension, ischemic changes in the right toes, and a pulsatile swelling behind the knee. In this ultrasonogram, the superior mesenteric artery has a beaded appearance. |
 | Media file 10: Angiogram of the same patient as in Image 9 in Multimedia confirms that the superior mesenteric artery has a beaded appearance. |
 | Media file 11: A poplitial artery aneurysm depicted by MRA and angiography (same patient as in Image 9-10 in Multimedia). |
 | Media file 12: A poplitial artery aneurysm seen on coronal T2 weighted images. The resected poplitial artery aneurysm showed intimal fibroplasia (same patient as in Images 9-11 in Multimedia). |
More on Fibromuscular Dysplasia (Visceral Arteries) |
| Overview: Fibromuscular Dysplasia (Visceral Arteries) |
| Imaging: Fibromuscular Dysplasia (Visceral Arteries) |
| Follow-up: Fibromuscular Dysplasia (Visceral Arteries) |
 Multimedia: Fibromuscular Dysplasia (Visceral Arteries) |
| References |
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Further Reading
Keywords
FMD, carotid artery stenosis, carotid artery aneurysm, visceral artery stenosis, visceral artery aneurysm, peripheral artery stenosis, peripheral artery aneurysm, renal artery stenosis, renal-artery stenosis, RAS, renal artery fibrosing lesions, intimal fibroplasia, medial fibrosis with microaneurysms, subadventitial fibroplasia, fibromuscular hyperplasia, segmental mediolytic arteriopathy, alpha-1-antitrypsin deficiency, AAT deficiency
