PMC3823385_01
38-year-old female with left gluteal swelling diagnosed with superior gluteal artery aneurysm. Contrast enhanced CT pelvis shows the aneurysm with a large extrapelvic (black arrow), a small intrapelvic components (white arrow) and Left superior gluteal artery (curved arrow). (a) Coronal reformat shows aneurysm extension through the greater sciatic notch. (b) and (c) Volume rendered images, internal and anterior views of the pelvis, demonstrate the two components of aneurysm and its origin from the superior gluteal artery.
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F1
The scan demonstrated a large pseudoaneurysm originating from the left superior gluteal artery measuring 6.4 x 5.8 x 3.4 cm with a small intra-pelvic component and large extra-pelvic component in the gluteal area [Figure 1].
38-year-old female with left gluteal swelling diagnosed with superior gluteal artery aneurysm. MRI pelvis axial plain images: (a) T1-weighted (b) T2-weighted images reveal the superior gluteal aneurysm has a signal void lumen (black arrow) and surrounding heterogeneous thrombus with predominantly high T1 and low T2 signal intensities (white arrow).
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F2
The aneurysm demonstrated mixed signal intensities; with rounded central signal-void area representing the patent lumen, and a peripheral thick rim of high signal intensity on T1-weighted and low signal intensity on T2-weighted images denoting a thrombus/hematoma [Figure 2].
38-year-old female with left gluteal swelling diagnosed with superior gluteal artery aneurysm. (a and b) DSA selective catheterization of internal iliac and superior gluteal artery demonstrate the pseudoaneurysm (broad black arrow). (c) DSA following successful embolization shows coils occluding aneurysm neck (black narrow arrows) with complete cessation of blood flow inside the aneurysm.
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F3
The aneurysm was approached by puncturing the right femoral artery and occluded by placing four coils and gelfoam in the feeding vessels [Figure 3].
38-year-old female with left gluteal swelling diagnosed with superior gluteal artery aneurysm. Follow-up studies shows exclusion of the aneurysm: (a and b) CT angiography one week postembolization, axial cut and volume rendered reformat (c) MRI axial STIR few months postembolization show aneurysm clips (white arrows), and residual hematoma (black arrows).
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F4
Repeated CT angiography after 1 week confirmed exclusion of the aneurysm with only a residual hematoma in the area [Figure 4a and b]. Follow-up MRI few months post-embolization showed significant reduction in the size of the hematoma [Figure 4c].