Melissa Hilmes1, Ramiro Hernandez, Eric Devaney. 1. Department of Radiology, C.S. Mott Children's Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0252, USA. rjhm@med.umich.edu
Abstract
BACKGROUND: Circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment is a rare anomaly of the aortic arch. Adequate surgical management relies on precise diagnosis, which might not be feasible with echocardiography. OBJECTIVE: To demonstrate the utility of MR imaging in establishing the diagnosis and to describe potential pitfalls in making the diagnosis. MATERIALS AND METHODS: Three patients with a circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment were retrospectively evaluated. All patients underwent evaluation by echocardiography and MR imaging. The MR imaging consisted of 3-D MR angiography in two patients and fast gradient recalled echo with cardiac-triggered segmented acquisition in one patient. Surgical confirmation was obtained on all three patients. RESULTS: The arch anatomy was accurately depicted in all three patients by MR imaging and in none of the patients by echocardiography. CONCLUSION: MR imaging is extremely useful in establishing the diagnosis of markedly hypoplastic retroesophageal circumflex right aortic arch and thus helps in surgical planning.
BACKGROUND:Circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment is a rare anomaly of the aortic arch. Adequate surgical management relies on precise diagnosis, which might not be feasible with echocardiography. OBJECTIVE: To demonstrate the utility of MR imaging in establishing the diagnosis and to describe potential pitfalls in making the diagnosis. MATERIALS AND METHODS: Three patients with a circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment were retrospectively evaluated. All patients underwent evaluation by echocardiography and MR imaging. The MR imaging consisted of 3-D MR angiography in two patients and fast gradient recalled echo with cardiac-triggered segmented acquisition in one patient. Surgical confirmation was obtained on all three patients. RESULTS: The arch anatomy was accurately depicted in all three patients by MR imaging and in none of the patients by echocardiography. CONCLUSION: MR imaging is extremely useful in establishing the diagnosis of markedly hypoplastic retroesophageal circumflex right aortic arch and thus helps in surgical planning.
Authors: Jonathan R Dillman; Anil K Attili; Prachi P Agarwal; Adam L Dorfman; Ramiro J Hernandez; Peter J Strouse Journal: Pediatr Radiol Date: 2011-05-19