Name : Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Resident : Ashraf Sadat Hoseini, Ramin Pourghorban
Gender : Female
Age : 34
A 34 year old woman with history of shortness of breath and chest pain
Imaging Procedures and Findings
On scout image (image 1) a large left mediastinal mass with smooth border is seen. Spiral CT angiographic images (images 2,3,4 and 5) demonstrate a large fusiform aortic arc aneurysm measuring 58Ãƒ?92 mm with wall calcification. Aortic arc aneurysm begins just after the origin of common carotid arteries. Aberrant right subclavian artery arises from descending aorta distal to the left sub clavian artery then crosses behind the esophagus. Volume-rendered reconstruction (image 6) confirms the findings.
An aortic aneurysm is defined as an abnormal permanent dilatation of the aorta. Since the aorta normally dilates with advancing age, the ????normal???? diameter is age dependent, but always less than 4 cm in diameter in the midascending aorta and less than 3 cm in the descending aorta . MDCT aortography and MR have virtually replaced conventional aortography for the detection and characterization of thoracoabdominal aortic aneurysms. Spiral CT allows accurate diagnosis of aortic aneurysm and readily distinguishes this from other mediastinal masses. It demonstrates all features of TAAs, including an accurate assessment of the shape, length, and diameter of the aneurysm; the presence of mural thrombus and calcification; and the relationship of the aneurysm to adjacent intrathoracic structures.
Aortic aneurysm and Aberrant right subclavian artery
Boiselle P,White C: New techniques in cardiothoracic imaging, 2nd ed. New York: Informa Healthcare, 2007.