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Radiology
Thoracic Aorta
Built from Fundamentals of Diagnostic Radiology
What’s inside
10 sections · 154 slides
Overview
- Divisions of the thoracic aorta
- 3D volume-rendered reformat of the thoracic aorta
Aortic Root, Valve, and Ascending Aorta
From the annulus to the sinotubular junction, then up to the arch origin.
- Aortic root boundaries
- Sinuses of Valsalva
- Aortic root and sinuses of Valsalva on CT
- Aortic root dimensions
- Aortic valve leaflets
- Congenital aortic valve anomalies
- Bicuspid aortic valve types
- Bicuspid aortic valve on MR and CT
- Bicuspid valve complications
- Unicuspid and quadricuspid valves
- Unicuspid aortic valve with ascending aneurysm
- Quadricuspid aortic valve (clover-leaf)
- Ascending aorta course
- ECG gating for aortic imaging
- Normal ascending aorta and left aortic arch
Aortic Arch and Branching Variants
The normal three-vessel left arch, its variants, and vascular rings.
- Aortic arch and great vessels
- Subclavian steal
- Subclavian steal on coronal CT
- Aortic isthmus and ductus bump
- Aortic isthmus and ductus bump
- Two-vessel and four-vessel arches
- Two-vessel aortic arch
- Four-vessel aortic arch
- Left arch with aberrant right subclavian artery
- Left arch with aberrant right subclavian artery
- Right aortic arch
- Right aortic arch on chest radiograph
- Right arch with aberrant left subclavian artery
- Right arch with aberrant left subclavian artery
- Right arch with mirror-image branching
- Right arch with mirror-image branching
- Double aortic arch
- Double aortic arch in an adult
- Double aortic arch causing a vascular ring
- Cervical aortic arch
- Cervical aortic arch
- Interrupted aortic arch
- Interrupted aortic arch types
- Type B interrupted aortic arch
- Circumflex aorta
- Circumflex aortic arch
Descending Aorta: Coarctation to Atheroma
The descending thoracic aorta, coarctation, pseudocoarctation, and atheroma.
- Descending thoracic aorta
- Aortic coarctation definition
- Two forms of aortic coarctation
- Collateral circulation in coarctation
- Aortic coarctation with collateral vessels
- Radiographic signs of coarctation
- Coarctation figure-of-3 sign and rib notching
- Coarctation flow acceleration on 4D flow
- Coarctation repair and follow-up
- Pseudocoarctation
- Pseudocoarctation
- Aortic atheroma risk factors
- Atheroma formation sequence
- Vulnerable plaque
- Diffuse thoracic aortic atherosclerosis
- Complex atheroma and plaque ulceration
- Complex atheroma with aneurysmal dilation
- Ulcerated plaque versus penetrating ulcer
Aortic Aneurysm
Sinus of Valsalva, ascending/arch, and descending thoracic aneurysms.
- Sinus of Valsalva aneurysm
- Sinus of Valsalva aneurysm
- Sinus of Valsalva rupture
- Thoracic aortic aneurysm definition
- Multifocal thoracoabdominal aortic aneurysm
- Causes of ascending and arch aneurysm
- Imaging thoracic aortic aneurysms
- Ascending thoracic aortic aneurysm
- Marfan syndrome with aortic and pulmonary dilation
- Aneurysm rupture risk
- Descending thoracic aortic aneurysm
- Descending aneurysm repair outcomes
Acute Aortic Syndrome
Aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer.
- Acute aortic syndrome triad
- Imaging acute aortic syndrome
- Stanford classification of dissection
- Dissection of the aortic arch
- How dissection begins
- Dissection cascade
- Where the tear occurs
- Complications of dissection
- Type A dissection with coronary and brachiocephalic involvement
- Type A dissection occluding the right common carotid
- Chest X-ray in dissection
- Type A dissection on chest radiograph
- CTA features of dissection
- Type B dissection with impending rupture
- Type B dissection with rupture
- Arch dissection on CT
- MR in aortic dissection
- Arch dissection on MR
- Intramural hematoma basics
- IMH on imaging
- Intramural hematoma progressing to type A
- IMH classification and course
- Penetrating atherosclerotic ulcer
- Penetrating atherosclerotic ulcer
- Penetrating ulcer with intramural hematoma
- PAU risk and treatment
Pseudoaneurysm, Fistulas, and Traumatic Injury
Contained rupture, abnormal connections, and blunt aortic trauma.
- Layers of the aortic wall
- Aortic pseudoaneurysm
- Proximal descending aortic pseudoaneurysm
- Pseudoaneurysm with aortobronchial fistula and hemorrhage
- Ascending aortic pseudoaneurysm
- Diagnosing pseudoaneurysm
- Aortic fistulas
- Aortoesophageal fistula
- Aortopleural fistula
- Imaging and treating fistulas
- Acute traumatic aortic injury spectrum
- Acute traumatic aortic injury
- Traumatic pseudoaneurysm of the aortic isthmus
- Imaging traumatic aortic injury
- Ductus bump versus traumatic injury
- Physiologic ductus bump
Postoperative Aorta and TEVAR
Normal repairs, complications, and endovascular stent-grafts.
- Imaging the postoperative aorta
- Grafts and repair techniques
- Composite valve-graft repair
- Elephant trunk repair
- Inclusion and elephant trunk techniques
- Postoperative complications
- Graft infection with perigraft abscess
- Graft pseudoaneurysm and fistula
- Thoracic endovascular aortic repair (TEVAR)
- Subclavian coverage during TEVAR
- Endoleaks
- Endoleak types I-III
- Type I endoleak
- Type III endoleak
- Other TEVAR complications
Aortitis and Aortic Tumors
Inflammatory disease of the aortic wall and rare aortic neoplasms.
- Aortitis causes
- Infectious aortitis
- Imaging aortitis
- Takayasu arteritis on CT and PET
- Takayasu arteritis on CT, MR, and PET
- Aortitis complications
- Aortic tumors
- Imaging aortic tumors
- Aortic sarcoma
- Aortic occlusion from tumor embolization
- Tumor embolization into the aorta
Summary
What to remember about imaging the thoracic aorta.
- Thoracic aorta: key takeaways
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Suggested Readings
- Brant and Helms' Fundamentals of Diagnostic Radiology