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ORIGINAL ARTICLES
Published online: 2020-08-22
Submitted: 2020-06-19
Accepted: 2020-08-13
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Which morphological abnormalities better define the elongation of transverse aortic arch; MR angiography study

H. Yiğit, E. Ergün, P. N. Koşar
DOI: 10.5603/FM.a2020.0100
·
Pubmed: 32844387

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-08-22
Submitted: 2020-06-19
Accepted: 2020-08-13

Abstract

Background: The aim of the study is to investigate the relation between morphological abnormalities that might indicate elongation of transverse aortic arch (ETA) and various aortic and thoracic measurements, and to determine which morphological criteria define the elongated transverse arch better. Materials and methods: Patients under 40 years of age who underwent contrast enhanced thoracic MR angiography were included in the study. Images were evaluated for the presence of morphological arch abnormalities such as late take off of left subclavian artery (LSA), flattening of the arch, and kinking at the posterior or anterior contour of the lesser curvature. Various aortic and thoracic measurements including the distance between the orifices of the left common carotid artery (LCCA) and LSA were made. Statistical relation between morphological abnormalities and these measurements was analyzed.  The effect of morphological abnormalities and their combinations on the distance between LCCA and LSA orifices was evaluated by linear regression analysis. Results: 93 cases were included in the study. All morphological abnormalities and most of their combinations show statistically significant relation with longer LCCA to LSA distance. The parameters that most affected this distance were combination of flattening with late take off (LTO) of LSA, anterior kinking and combination of anterior kinking with both flattening and LTO, respectively. Conclusions: Our study showed that the finding which best defines elongation of transverse aortic arch is the combination of LTO and arch flattening. Therefore, we recommend using this combination in the diagnosis of ETA instead of the classical diagnostic criteria including combination of LTO and posterior kinking.

Abstract

Background: The aim of the study is to investigate the relation between morphological abnormalities that might indicate elongation of transverse aortic arch (ETA) and various aortic and thoracic measurements, and to determine which morphological criteria define the elongated transverse arch better. Materials and methods: Patients under 40 years of age who underwent contrast enhanced thoracic MR angiography were included in the study. Images were evaluated for the presence of morphological arch abnormalities such as late take off of left subclavian artery (LSA), flattening of the arch, and kinking at the posterior or anterior contour of the lesser curvature. Various aortic and thoracic measurements including the distance between the orifices of the left common carotid artery (LCCA) and LSA were made. Statistical relation between morphological abnormalities and these measurements was analyzed.  The effect of morphological abnormalities and their combinations on the distance between LCCA and LSA orifices was evaluated by linear regression analysis. Results: 93 cases were included in the study. All morphological abnormalities and most of their combinations show statistically significant relation with longer LCCA to LSA distance. The parameters that most affected this distance were combination of flattening with late take off (LTO) of LSA, anterior kinking and combination of anterior kinking with both flattening and LTO, respectively. Conclusions: Our study showed that the finding which best defines elongation of transverse aortic arch is the combination of LTO and arch flattening. Therefore, we recommend using this combination in the diagnosis of ETA instead of the classical diagnostic criteria including combination of LTO and posterior kinking.

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Keywords

elongation of transverse aortic arch, cardiovascular abnormalities, anatomy, magnetic resonance angiography

About this article
Title

Which morphological abnormalities better define the elongation of transverse aortic arch; MR angiography study

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2020-08-22

DOI

10.5603/FM.a2020.0100

Pubmed

32844387

Keywords

elongation of transverse aortic arch
cardiovascular abnormalities
anatomy
magnetic resonance angiography

Authors

H. Yiğit
E. Ergün
P. N. Koşar

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