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Case #23

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Demographics: 61 years old, Female
Indication: Chest pain, history of bicuspid aortic valve

Case #23

Findings

Chest radiograph

  • Bulging contour of the ascending thoracic aorta
  • Surgical clips to the right of midline at the thoracic inlet

CT

Chest

  • Ascending aortic aneurysm measuring up to 5 cm
  • Normal aortic diameter in the arch and at the sinotubular junction
  • No dissection
  • Fish mouth configuration of the aortic valve
  • Subendocardial hypoattenuation at the left ventricular apex
  • Surgical changes of left and partial right thyroidectomy

Upper abdomen

  • No acute findings

MSK

  • No acute findings

Diagnosis

Ascending aortic aneurysm

Sample Report

Ascending aortic aneurysm measuring up to 5 cm in diameter without aneurysmal dilation of the aortic arch or sinotubular junction.

Fish mouth configuration of the aortic valve consistent with known bicuspid aortic valve.

Subendocardial hypoattenuation at the left ventricular apex, likely sequela of myocardial infarction.

Discussion

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References

  • Agarwal PP, Chughtai A, Matzinger FR, Kazerooni EA. Multidetector CT of thoracic aortic aneurysms. Radiographics 2009; 29: 537-552.
  • Munden RF, Carter BW, Chiles C, et al. Managing incidental findings on thoracic CT: mediastinal and cardiovascular findings. A white paper of the ACR Incidental Findings Committee. J Am Coll Radiol 2018; 15: 1087-1096.

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