Vascular abnormalities

Question 0

Aortic Aneurysm

Answer 0

> 6 requires surgery

aortic wall thickened, calcification common

Question 1

Aberrant right subclavian artery

Answer 1

arises last of the aorta
passes behind esophagus and can cause dysphagia
can arise from aortic diverticulum (diverticulum of Kommerell)

Question 2

Aortic laceration

Answer 2

mediastinal hematoma contiguous with aorta

can get post-traumatic pseudoaneurysm (ligamentum and aortopulmomary window)

Question 3

aortic dissection - classifications

Answer 3

DeBakey:
Type I entire aorta
Type II ascending
Type III descending

Stanford:
A: Ascending
B: Descending

Question 4

False Lumen

Answer 4

lateral to TL-spiral posterior in DA. Can effect the left renal artery.
FL is bigger
FL - irregular contour and can have cobwebs
contains thrombus
blood flow slowest and opacification delayed
wall calcification can be seen in lateral wall of TL

Question 5

Intramural Hematoma

Answer 5

Contrast Enhanced: crescentic, smooth

Unenhanced: denser blood

Question 6

Penetrating atherosclerotic Ulcer

Answer 6

penetrates intima and aortic wall

Question 7

Persistent Left Superior Vena Cava

Answer 7

located left of left carotid a. in supraortic mediastinum
enters at coronary sinus posterior to L atrium
occurs concurrently with R SVC and is the same size

Question 8

Azygos/Hemiazygos continuation of IVC

Answer 8

Az and Haz veins connect to IVC
associated with congenital abnormalities: polysplenia, asplenia
Dilated Az v. with +/- dilated Hemiazygos vein that crosses midline
(Az v usually drains to SVC, HAz v drains to left brachiocephalic)

Question 9

SVC obstxn

Answer 9

seen in bronchogenic CA, Histoplasmosis (granulomatous mediastinitis), sarcoid, TB, post RX, iatragenic from catherters
- can see dilated collaterals (Az v and intercostal v.)

Question 10

Pulmonary HTN

Answer 10

> 3.0 cm diameter or bigger than the aorta

Question 11

Pulmonary stenosis

Answer 11

-Main and left P. arteries dilated. Right pulm artery is normal caliber

Question 12

Donut Sign - PE

Answer 12

thrombus centered with in the lumen seen on cross section

Question 13

Railroad track sign

Answer 13

longitudinal cross section of PE

Question 14

PE

Answer 14

<60 H w/ opacified blood measuring ~200
worm-shaped
seen on multiple planes
Chronic - adhere to outside/periphery with blood in the middle. Can see pulmonary artery webs can indicate prior PE