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CT Findings of Double Aortic Arch in an Older Adult: Recognizing a Right-Dominant Complete Vascular Ring

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Edited by ScholarGen MediAI Team Executive Answer A double aortic arch is a congenital aortic arch anomaly in which both right and left aortic arches persist and form a vascular ring around the trachea and esophagus. In this case, a man in his 70s presented with chest pain and underwent CT pulmonary angiography (CTPA) to evaluate for pulmonary embolism. No acute pulmonary embolism was identified. Instead, CT revealed a right-dominant double aortic arch forming a complete vascular ring . The key radiologic task is not simply to recognize two arches, but to define arch dominance, branch-vessel anatomy, and the relationship of the vascular ring to the trachea and esophagus. Why This Case Matters A CT examination is ordered for a clinical reason, but the images often contain diagnostic information far beyond the initial question. This case is a good example. A man in his 70s presented with chest pain, and CTPA was performed to exclude acute pulmonary embolism. The pulmonary arteries showed...
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Spinal Epidural Angiolipoma: MRI Diagnosis of a Posterior Epidural Mass Causing Progressive Leg Weakness

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  Edited by ScholarGen MediAI Team Executive Answer Spinal epidural angiolipoma is a rare benign spinal tumor composed of mature adipose tissue and vascular components. The characteristic imaging pattern is a posterior epidural mass containing both fat and enhancing vascular tissue , often producing spinal cord compression. In this case, a woman in her late 50s presented with progressive bilateral leg weakness and sensory disturbance. MRI demonstrated a spindle-shaped posterior epidural mass extending from T6 to T8 , compressing the spinal cord. Mixed T1 signal, T2 hyperintensity, and heterogeneous enhancement strongly supported the diagnosis. Recognizing the combination of epidural location + fat + vascular enhancement + cord compression is more useful than identifying fat alone. Why This Case Matters A patient with progressive bilateral leg weakness does not always have degenerative lumbar spine disease. That distinction matters. When weakness progresses over time and is accompa...
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Crohn Disease-Associated Small Bowel Adenocarcinoma: CT and MRI Findings of a Duodenal Cancer with Liver Metastasis

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  Edited by ScholarGen MediAI Team A radiologic approach to asymmetric bowel-wall thickening, obstruction, lymphadenopathy, and metastatic disease in Crohn disease Executive Answer Small bowel adenocarcinoma is an uncommon but clinically important malignancy in patients with Crohn disease. The diagnostic challenge is that its symptoms and imaging appearance can overlap with active inflammation or fibrostenotic Crohn disease. In this case, a man in his late 30s presented with abdominal pain and vomiting. CT demonstrated focal asymmetric duodenal wall thickening with regional lymphadenopathy and a separate low-attenuation liver lesion. MRI demonstrated abnormal bowel-wall thickening and diffusion restriction, with a corresponding abnormal liver lesion. Biopsy established poorly differentiated adenocarcinoma in the duodenum and moderately differentiated adenocarcinoma in the liver, consistent with metastatic small bowel adenocarcinoma. The central imaging lesson is simple: a new, foca...
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