Limits...
Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography.

Türkvatan A, Büyükbayraktar FG, Olçer T, Cumhur T - Korean J Radiol (2009)

Bottom Line: Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases.Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch.In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, TürkIye Yüksek Ihtisas Hospital, Ankara, Turkey. aturkvatan@yahoo.com

ABSTRACT
Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.

Show MeSH

Related in: MedlinePlus

Aberrant right subclavian artery in 51-year-old woman with dysphagia is shown. Anterior volume rendering image shows aberrant right subclavian artery (ARSA) and common origin of carotid arteries (arrow). RCA = right carotid artery, LCA = left carotid artery, LSA = left subclavian artery
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2651449&req=5

Figure 7: Aberrant right subclavian artery in 51-year-old woman with dysphagia is shown. Anterior volume rendering image shows aberrant right subclavian artery (ARSA) and common origin of carotid arteries (arrow). RCA = right carotid artery, LCA = left carotid artery, LSA = left subclavian artery

Mentions: An ARSA originating from normal left sided aortic arch is the most common aortic arch anomaly, with an incidence of 0.5-2% (5). This anomaly results from interruption of the dorsal segment of the right arch between the right carotid artery and right subclavian artery with regression of the right ductus arteriosus in the developing double aortic arch (4) (Fig. 2). In this anomaly, the right carotid artery arises as the first branch directly from the aortic arch, which is followed by the left carotid artery, left subclavian arteries and ARSA (Fig. 3). The ARSA arises from the descending aorta as a last branch and crosses the mediastinum from left to right, passing behind the esophagus and trachea (Figs. 3, 4). An aortic diverticulum, also known as Kommerell's diverticulum, may be present at the origin of this vessel and has been reported in up to 60% of cases, representing the remnant of the distal RAA (6) (Fig. 3). An ARSA is generally asymptomatic and has been diagnosed incidentally, but about 10% of adults with this anomaly have symptoms of dysphagia due to extrinsic compression of the esophagus due to its retroesophageal course (Fig. 5). Rarely, with failure regression of the right ductus, a loose vascular ring may be formed by the LAA with an ARSA, right pulmonary artery and right ductus arteriosus (1). Aneurysmal dilatation of the proximal portion of an ARSA is uncommon. Such an aneurysm may or may not be associated with Kommerell's diverticulum, and is believed to be the result of atherosclerotic disease (6) (Fig. 3). Generally, this anomaly is isolated, but may be associated with other cardiovascular anomalies, principally with coarctation of the aorta (Fig. 6), a patent ductus arteriosus, intracardiac defects, anomalous pulmonary artery circulation and carotid or vertebral artery anomalies (5, 7) (Fig. 7).


Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography.

Türkvatan A, Büyükbayraktar FG, Olçer T, Cumhur T - Korean J Radiol (2009)

Aberrant right subclavian artery in 51-year-old woman with dysphagia is shown. Anterior volume rendering image shows aberrant right subclavian artery (ARSA) and common origin of carotid arteries (arrow). RCA = right carotid artery, LCA = left carotid artery, LSA = left subclavian artery
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651449&req=5

Figure 7: Aberrant right subclavian artery in 51-year-old woman with dysphagia is shown. Anterior volume rendering image shows aberrant right subclavian artery (ARSA) and common origin of carotid arteries (arrow). RCA = right carotid artery, LCA = left carotid artery, LSA = left subclavian artery
Mentions: An ARSA originating from normal left sided aortic arch is the most common aortic arch anomaly, with an incidence of 0.5-2% (5). This anomaly results from interruption of the dorsal segment of the right arch between the right carotid artery and right subclavian artery with regression of the right ductus arteriosus in the developing double aortic arch (4) (Fig. 2). In this anomaly, the right carotid artery arises as the first branch directly from the aortic arch, which is followed by the left carotid artery, left subclavian arteries and ARSA (Fig. 3). The ARSA arises from the descending aorta as a last branch and crosses the mediastinum from left to right, passing behind the esophagus and trachea (Figs. 3, 4). An aortic diverticulum, also known as Kommerell's diverticulum, may be present at the origin of this vessel and has been reported in up to 60% of cases, representing the remnant of the distal RAA (6) (Fig. 3). An ARSA is generally asymptomatic and has been diagnosed incidentally, but about 10% of adults with this anomaly have symptoms of dysphagia due to extrinsic compression of the esophagus due to its retroesophageal course (Fig. 5). Rarely, with failure regression of the right ductus, a loose vascular ring may be formed by the LAA with an ARSA, right pulmonary artery and right ductus arteriosus (1). Aneurysmal dilatation of the proximal portion of an ARSA is uncommon. Such an aneurysm may or may not be associated with Kommerell's diverticulum, and is believed to be the result of atherosclerotic disease (6) (Fig. 3). Generally, this anomaly is isolated, but may be associated with other cardiovascular anomalies, principally with coarctation of the aorta (Fig. 6), a patent ductus arteriosus, intracardiac defects, anomalous pulmonary artery circulation and carotid or vertebral artery anomalies (5, 7) (Fig. 7).

Bottom Line: Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases.Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch.In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, TürkIye Yüksek Ihtisas Hospital, Ankara, Turkey. aturkvatan@yahoo.com

ABSTRACT
Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch.

Show MeSH
Related in: MedlinePlus