Key result
Late-phase CT and MRI correctly diagnose dilated azygos veins that mimic malignant tumors on dynamic CT.
Case Report (n=1)
Dynamic CT can present a potential pitfall in diagnosing vascular structures like azygos aneurysms, which may mimic malignant tumors in early arterial phases; MRI can confirm the diagnosis.
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Dynamic CT pitfalls in azygos dilation warrant venous-phase review before tumor suspicion; case reports leave optimal protocols open.
We present a case of azygos vein continuation with aneurysm of the azygos vein simulating a tumor in the right upper mediastinum. The dynamic CT examination initially showed a structure of malignant appearance during the early arterial phase. Further dynamic CT revealed marked enhancement of the mass during the late venous phase, suggesting a vascular structure. Confirmation of diagnosis was made by MRI using a fast gradient echo imaging technique in cine mode, showing turbulent flow in the azygos aneurysm, and contrast-enhanced MR angiography, demonstrating a dilated azygos vein. Dynamic CT has a potential pitfall in the diagnosis of vascular structures.
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Poll et al. (1999) conducted a case report in Azygos Continuation Syndrome with Aneurysm of the Azygos Vein (n=1). Dynamic CT and MRI was evaluated on Diagnosis of vascular structure. Dynamic CT initially simulated a malignant tumor, but late venous phase CT and MRI confirmed a dilated azygos vein, highlighting a potential diagnostic pitfall of dynamic CT.
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