34 year old female with shortness of breath and chest pain

 

Images

Doctor's Information

Name : Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Ashraf Sadat Hoseini, Ramin Pourghorban

 

Patient's Information

Gender : Female
Age : 34

 

Case Section

Cardiovascular

 

Clinical Summary

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 58Ã?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.

 

Discussion

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.

 

Final Diagnosis

Aortic aneurysm and Aberrant right subclavian artery

 

References

Boiselle P,White C: New techniques in cardiothoracic imaging, 2nd ed. New York: Informa Healthcare, 2007.

 

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