MediAI

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...

A radiologist’s approach to quadricuspid pulmonary valve: CT diagnosis, four-cusp morphology, differential diagnosis, pulmonary regurgitation, pulmonary artery aneurysm, multimodality imaging, management, and prognosis. By Hwunjae Lee, MD, PhD Introduction A 43-year-old woman presented with sudden epigastric pain radiating to the back . That clinical description immediately raises an important diagnostic concern. Sudden severe upper abdominal or epigastric pain extending toward the back can represent acute aortic syndrome (AAS) , including aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, or aortic rupture. In an emergency setting, these potentially fatal conditions must be excluded rapidly. CT angiography was therefore performed. The aorta was unremarkable for an acute aortic catastrophe. There was no convincing aortic dissection, penetrating atherosclerotic ulcer, intramural hematoma, rupture, or pericardial effusion. However, the examination contained an une...

  Anomalous Right Coronary Artery From the Left Coronary Cusp With Interarterial Course: A Coronary CT Angiography Guide to Diagnosis, Risk Stratification, Treatment, Prognosis, and AI By Dr. SB Lee Abstract A 30-year-old man presented with intermittent chest pain during exercise despite an otherwise unremarkable initial cardiac evaluation. Coronary CT angiography (CCTA) demonstrated an anomalous origin of the right coronary artery (RCA) from the left coronary cusp rather than the normal right coronary sinus. The anomalous RCA subsequently coursed between the great vessels, producing an interarterial course . Importantly, the coronary ostium demonstrated a slit-like morphology and an acute take-off angle , two anatomic features that may increase concern for dynamic coronary flow limitation. This case illustrates why coronary CT angiography should not be interpreted simply as a search for coronary stenosis or calcified plaque. In patients with suspected anomalous aortic origin of a...