Learning objectives
Todemonstrate the embryology and anatomy of the aortic arch and its branches,
the main types of congenital variants and anomalies,
as well as other less common malformations in this spectrum,
throughcross-sectional imaging withMultidetector Computed Tomography (MDCT) angiography and Magnetic Resonance Angiography (MRA),
showing the main three-dimensional post-processing techniques.
Background
Embryology of aorticarch and its branches
The most common anatomy of the aortic arch,
present in approximately 70% of humans,
is represented by three great vessels originating from it: innominate artery (IA),
left common carotid artery (LCCA) and left subclavian artery (LCSA).
TheIA subsequently branches into the right common carotid artery (RCCA) and the right subclavian artery (RSCA).
The vertebral arteries originate from the corresponding subclavian arteries.
The most widely recognized aortic arch development theory is the Rathke's diagram.
According to it,
six pairs of...
Findings and procedure details
Common origin of the innominate artery and left common carotid artery.
Origin of the left common carotid artery from the innominate artery.
Many authors consider that these two variants can be erroneously named "bovine" arch,
since the aortic arch of cattle is not presented in a similar way.
However,
other studies consider only the common origin of the innominate artery and left common carotid artery as a “bovine” arch.
Fig. 3
Both aortic arch branching pattern is found more often in blacks.The common origin of...
Conclusion
Congenital anomalies of the aortic arch are part of a rare spectrum of cardiovascular diseases and result from the embryogenesis disorder ofbranchial arches.
Familiarity with these abnormalities and their imaging appearance is necessary to elucidate the diagnosis,
guide the treatment and interventions.
Non-invasive MDCT and MR angiography allow complete evaluation of the aortic arch and its branches.
The three-dimensional reconstructions improve the evaluation of the anatomical relation of the aortic arch with adjacent structures,
such as the trachea and esophagus.
References
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