Advertisement

Anatomical Overview and Imaging of the Aorta and Visceral Arteries

  • Gabriele Ironi
  • Giorgio Brembilla
  • Giulia Benedetti
  • Francesco De CobelliEmail author
Chapter

Abstract

The thoracic aorta extends proximally from the aortic annulus to the diaphragmatic crura distally. It is subdivided into three parts: the ascending aorta, the arch and the descending aorta. The ascending aorta comprises the aortic root and the tubular ascending aorta. The aortic root lies between the aortic annulus and the sinotubular junction. The sinuses of Valsalva arise from the aortic root. The tubular ascending aorta runs from the sinotubular junction to the brachiocephalic trunk. The coronary arteries are the only branches of the ascending aorta. The aortic arch begins at the brachiocephalic trunk and ends at the origin of the left subclavian artery. The isthmus extends from the left subclavian artery to the ligamentum arteriosum. Three branches usually arise from the aortic arch: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The brachiocephalic trunk divides into the right common carotid artery and the right subclavian artery. In 6% of people, the left vertebral artery arises directly from the arch [1]. The bovine arch is another variant in which the left common carotid artery arises from the brachiocephalic trunk rather than the aorta [1]. Another arch variant is the ductus diverticulum, a focal bulge along the inner aspect of the isthmus representing a remnant of the ductus arteriosus. Traumatic aortic transection also occurs in this location and can occasionally be difficult to differentiate from a ductus diverticulum. However, the ductus diverticulum has smooth margins with obtuse angles relative to the adjacent aorta. Aortic transection has irregular margins with acute angles relative to the nearby aortic walls.

References

  1. 1.
    Berko NS, Jain VR, Godelman A, Stein EG, Ghosh S, Haramati LB. Variants and anomalies of thoracic vasculature on computed tomographic angiography in adults. J Comput Assist Tomogr. 2009;33:523–8.CrossRefGoogle Scholar
  2. 2.
    Liu PS, Platt JF. CT angiography of the renal circulation. Radiol Clin N Am. 2010;48:347–65.CrossRefGoogle Scholar
  3. 3.
    Budovec JJ, Pollema M, Grogan M. Update on multidetector computed tomography angiography of the abdominal aorta. Radiol Clin N Am. 2010;48:283–309.CrossRefGoogle Scholar
  4. 4.
    Ugurel MS, Battal B, Bozlar U, Nural MS, Tasar M, Ors F, Saglam M, Karademir I. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol. 2010;83:661–7.CrossRefGoogle Scholar
  5. 5.
    Guirguis-Blake JM, Beil TL, Senger CA, Whitlock EP. Ultrasonography screening for abdominal aortic aneurysms: a systematic evidence review for the U.S. preventive services task force. Ann Intern Med. 2014;160:321–9.CrossRefGoogle Scholar
  6. 6.
    Raman KG, Missig-Carroll N, Richardson T, Muluk SC, Makaroun MS. Color-flow duplex ultrasound scan versus computed tomographic scan in the surveillance of endovascular aneurysm repair. J Vasc Surg. 2003;38(4):645–51.CrossRefGoogle Scholar
  7. 7.
    Moneta GL, Lee RW, Yeager RA, Taylor LM, Porter JM. Mesenteric duplex scanning: a blinded prospective study. J Vasc Surg. 1993;17:79–86.CrossRefGoogle Scholar
  8. 8.
    Pellerito JS, Revzin MV, Tsang JC, Greben CR, Naidich JB. Doppler sonographic criteria for the diagnosis of inferior mesenteric artery stenosis. J Ultrasound Med. 2009;28:641–50.CrossRefGoogle Scholar
  9. 9.
    Aburahma AF, Mousa AY, Stone PA, Hass SM, Dean LS, Keiffer T. Duplex velocity criteria for native celiac/superior mesenteric artery stenosis vs in-stent stenosis. J Vasc Surg. 2012;55:730–8.CrossRefGoogle Scholar
  10. 10.
    Olin JW, Piedmonte MR, Young JR, DeAnna S, Grubb M, Childs MB. The utility of duplex ultrasound scanning of the renal arteries for diagnosing significant renal artery stenosis. Ann Intern Med. 1995;122:833–8.CrossRefGoogle Scholar
  11. 11.
    Radermacher J, Chavan A, Bleck J, et al. Use of Doppler ultrasonography to predict the outcome of therapy for renal-artery stenosis. N Engl J Med. 2001;344:410–7.CrossRefGoogle Scholar
  12. 12.
    Mohabbat W, Greenberg RK, Mastracci TM, Cury M, Morales JP, Hernandez AV. Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms. J Vasc Surg. 2009;49:827–37.CrossRefGoogle Scholar
  13. 13.
    Gürtler VM, Sommer WH, Meimarakis G, Kopp R, Weidenhagen R, Reiser MF, Clevert DA. A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after endovascular aneurysm repair. J Vasc Surg. 2013;58:340–5.CrossRefGoogle Scholar
  14. 14.
    Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology. 2010;256:32–61.CrossRefGoogle Scholar
  15. 15.
    Fleischmann D. CT angiography: injection and acquisition technique. Radiol Clin N Am. 2010;48:237–47.CrossRefGoogle Scholar
  16. 16.
    Scheske JA, Chung JH, Abbara S, Ghoshhajra BB. Computed tomography angiography of the thoracic aorta. Radiol Clin N Am. 2016;54:13–33.CrossRefGoogle Scholar
  17. 17.
    Hara AK, Paden RG, Silva AC, Kujak JL, Lawder HJ, Pavlicek W. Iterative reconstruction technique for reducing body radiation dose at CT: feasibility study. Am J Roentgenol. 2009;193:764–71.CrossRefGoogle Scholar
  18. 18.
    Schneider G, Prince MR, Meaney JFM, Ho VB. Magnetic resonance angiography. Berlin: Springer; 2005. p. 358.CrossRefGoogle Scholar
  19. 19.
    Korosec FR, Mistretta CA. MR angiography: basic principles and theory. Magn Reson Imaging Clin N Am. 1998;6:223–56.PubMedGoogle Scholar
  20. 20.
    Keller PJ, Drayer BP, Fram EK, Williams KD, Dumoulin CL, Souza SP. MR angiography with two-dimensional acquisition and three-dimensional display. Work in progress. Radiology. 1989;173:527–32.CrossRefGoogle Scholar
  21. 21.
    Laub GA, Kaiser WA. MR angiography with gradient motion refocusing. J Comput Assist Tomogr. 1988;12:377–82.CrossRefGoogle Scholar
  22. 22.
    Laub G, Gaa J, Drobnitzky M. Magnetic resonance angiography techniques. Electromedica. 1998;66:68–75.Google Scholar
  23. 23.
    Dyverfeldt P, Bissell M, Barker AJ, et al. 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson. 2015;17:72.CrossRefGoogle Scholar
  24. 24.
    Vasanawala SS, Hanneman K, Alley MT, Hsiao A. Congenital heart disease assessment with 4D flow MRI. J Magn Reson Imaging. 2015;42:870–86.CrossRefGoogle Scholar
  25. 25.
    Deshpande VS, Shea SM, Laub G, Simonetti OP, Finn JP, Li D. 3D magnetization-prepared true-FISP: a new technique for imaging coronary arteries. Magn Reson Med. 2001;46:494–502.CrossRefGoogle Scholar
  26. 26.
    Lohan DG, Saleh R, Nael K, Krishnam M, Finn JP. Contrast-enhanced MRA versus nonenhanced MRA: pros and cons. Appl Radiol. 2007;36:3–15.Google Scholar
  27. 27.
    Lin J, Li D, Yan F. High-resolution 3D contrast-enhanced MRA with parallel imaging techniques before endovascular interventional treatment of arterial stenosis. Vasc Med. 2009;14:305–11.CrossRefGoogle Scholar
  28. 28.
    Kirchin M, Runge V. Contrast agents for magnetic resonance imaging: safety update. Top Magn Reson Imaging. 2003;14:426–35.CrossRefGoogle Scholar
  29. 29.
    Laurent S, Vander EL, Muller RN. Comparative study of the physicochemical properties of six clinical low molecular weight gadolinium contrast agents. Contrast Media Mol Imaging. 2006;1:128–37.CrossRefGoogle Scholar
  30. 30.
    Runge VM. Safety of magnetic resonance contrast media. Top Magn Reson Imaging. 2001;12:309–14.CrossRefGoogle Scholar
  31. 31.
    Calhoun PS, Kuszyk BS, Heath DG, Carley JC, Fishman EK. Three-dimensional volume rendering of spiral CT data: theory and method. RadioGraphics. 1999;19:745–64.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gabriele Ironi
    • 1
    • 2
  • Giorgio Brembilla
    • 1
    • 2
  • Giulia Benedetti
    • 1
    • 2
  • Francesco De Cobelli
    • 1
    • 2
    Email author
  1. 1.Department of Radiology and Experimental Imaging CenterSan Raffaele Scientific InstituteMilanItaly
  2. 2.Vita-Salute San Raffaele UniversityMilanItaly

Personalised recommendations