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MR angiography of aberrant left subclavian artery arising from right-sided thoracic aortic arch

Department of Radiology, Northwestern Memorial Hospital, 448 East Ontario Street, Suite 300, Chicago, Illinois 60611, USA

View larger version (99K): [in a new window]   Figure 1. Barium swallow images demonstrating (a) severe reflux of barium on the supine lateral view with anterior displacement of the upper oesophagus (arrow) and an obliquely orientated impression (arrows) upon the upper thoracic oesophagus at the level of the 4th thoracic vertebra on (b) the anteroposterior (AP) and (c) right anterior oblique (RAO) views.

View larger version (95K): [in a new window]   Figure 2. Axial single-shot balanced gradient echo (True-FISP) MR images demonstrating: (a) the right-sided aortic arch with origin of the aberrant left subclavian artery from a diverticulum of Kommerell (arrow) located posterior to the oesophagus and trachea and (b) the descending thoracic aorta (arrow) to the right of the vertebral column. (c) Coronal True-FISP MR image shows the diverticulum of Kommerell (arrow) in relation to the right-sided aortic arch and descending aorta (arrowheads).

View larger version (49K): [in a new window]   Figure 3. Maximal intensity projection (MIP) image from the aortic phase measurement of time-resolved imaging of contrast kinetics (TRICKS) contrast enhanced magnetic resonance angiography (MRA) (time to acquire data=2.54 s). The aberrant left subclavian artery and diverticulum of Kommerell are demonstrated clearly (arrow). (b) Anterior and (c) posterior projected volume rendered reformats of the source data from (a) illustrate the relations of the vessels arising from the right-sided thoracic arch.