EURORAD ESR

Case 115

Atherosclerotic aneurysm of the thoracic aorta

Author(s)
E. Bassetti, I. Carbone, C. Catalano
 
Patient
male, 87 year(s)

Clinical History

An 88 years old man with a past history of hypertension. A chest X Ray showed a thoracic mass that had been revealed an aortic thoracic aneurysm by a CT angiography. The patient is doing well.

Imaging Findings

An 88 years old man. He had a past history of hypertension (150/95) without any other incident of note. Last November he underwent a chest X Ray before surgery. The X Ray showed a buldging of the left hilum. A CT angiography of the chest revealed an atherosclerotic sacciform aneurysm of the thoracic aorta. The vascular surgeon decided not to operate and the patient is following by our institution every 3 months. At the moment the patient is doing well.

Discussion

Many are the causes for the etiology of thoracic aortic aneurysm: Atherosclerosis, cystic medial degeneration, myxomatous degeneration, dissection, infection, trauma and post stenotic dilatation. The incidence of thoracic aortic aneurysm increases with age. They could be symptomatic, but often a routine chest film reveals an asymptomatic thoracic aneurysm. Actually, by using CT or MR angiography there is a diagnosis accuracy of almost 100%.

Final Diagnosis

Atherosclerotic sacciform aneurysm of the thoracic aorta
 

MeSH

  1. Aorta, Thoracic [A07.231.114.056.372]
    The portion of the descending aorta proceeding from the arch of the aorta and extending to the diaphragm.

References

  1. [1]
    Caimmi P et al. Aortic arch aneurysms: surgical results and follow up in 56 patients. Cardivasc Surg 1998 Oct; 6(5): 463-9.

  2. [2]
    Balm et al. Spiral CT angiography of the aorta. Eur J Vasc Surg 1994 Sep; 8(5):544-51.

  3. [3]
    Rubin GD Helical CT angiography of the aorta J Thorac Imaging 1997 Apr; 12(2): 128-49.

  4. [4]
    Chung JW et al. Spiral Ct angiography of the thoracic aorta. Radiographics 1996 Jul; 16(4):811-24.

  5. [5]
    Kopecky KK et al. Spiral Ct angiography of the aorta Semin Ultrasound CT MR 1996 Aug; 17(4): 304-15..

Citation

E. Bassetti, I. Carbone, C. Catalano (2000, Jul 31).
Atherosclerotic aneurysm of the thoracic aorta, {Online}.
URL: http://www.eurorad.org/case.php?id=115
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  • Figure 1
    Chest X-Ray PA view

    The image shows the presence of a round opacity of 4.5 cm of diameter in the iuxtailar region, without the evidence of the “silouette sign”, demonstrating the anterior position of the expansive formation. The mass has some periferal...

     
  • Figure 2
    Chest X-Ray. Lateral view

    The lateral radiogram confirms the anterior position of the mass, localized near the anterior portion of the aortic arch.

     
  • Figure 3
    Spiral CT images after the administration of contrast medium.
    a b c d  

    Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.

    Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.

    Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.

    Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.

     
Figure 1

Chest X-Ray PA view

The image shows the presence of a round opacity of 4.5 cm of diameter in the iuxtailar region, without the evidence of the “silouette sign”, demonstrating the anterior position of the expansive formation. The mass has some periferal calcifications.
 
Figure 2

Chest X-Ray. Lateral view

The lateral radiogram confirms the anterior position of the mass, localized near the anterior portion of the aortic arch.
 
Figure 3

Spiral CT images after the administration of contrast medium.

Figure 3a
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
 
Figure 3b
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
 
Figure 3c
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
 
Figure 3d
Presence of a sacciform aneurysm of the thoracic aorta (5 cm x 4 cm), that originates in the external profile of the aortic arch with a large parietal thrombos. The exam confirms the presence of calcifications.
 
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