Pulmonary Sling:
Aberrant Left pulmonary artery coming off the right pulmonary artery.
The only anomaly to create indentations in the posterior trachea and anterior oesophagus.
Adamkiewicz:
the great anterior medullary artery which serves as a dominate feeder of the spinal cord.
Usually comes off on the left side (70%) between T9-T12.
A vessel in the fissure of the ligamentum venosum is probably
an accessory or replaced left hepatic artery arising from the left gastric artery.
Arc of Riolan -
Also referred to as the meandering mesenteric artery.
Classically a connection between the middle colic of the SMA and the left colic of the IMA.
Marginal Artery of Drummond -
This is another SMA to IMA connection.
The anastomosis of the terminal branches of the ileocolic, right colic and middle colic arteries of the SMA, and of the left colic and sigmoid branches of the IMA, form a continuous arterial circle or arcade along the inner border of the colon.
Winslow Pathway -
seen in the setting of aorto-iliac occlusive disease.
The pathway runs from subclavian arteries -> internal thoracic (mammary) arteries -> superior epigastric arteries -> inferior epigastric arteries -> external iliac arteries.
Corona Mortis -
a vascular connection between the obturator and external iliac
any vessel coursing over the superior pubic rim, regardless of the anastomotic connection - bad in pelvic trauma/injured in surgery
Most gastric varices are formed by
the left gastric (coronary vein)
Isolated gastric varices are secondary to
splenic vein thrombosis.
Gastric Varices (80-85%) drain into the
inferior phrenic and then into the left renal vein, forming a gastro-renal shunt.
An enlarged left renal vein and dilatation of the inferior vena cava at the level of the left renal vein.
Splenorenal Shunt
Most commonly associated CHD with left sided SVC
ASD
Left sided SVC drains into
The coronary sinus
Duplicated IVC is associated with
horseshoe kidney
crossed fused ectopic kidneys
often have circumaortic renal collars
Circumaortic Venous Collar -
Common variant with an additional left renal vein that passes posterior to the aorta.
The anterior limb is superior, and the posterior limb is inferior.
Azygos Continuation -
This is also known as absence of the hepatic segment of the IVC.
In this case, the hepatic veins drain directly into the right atrium.
No IVC in the liver, dilated azygous in the chest
At risk of aortic dissection -
HYPERTENSION
Marfans, Turners, other CT diseases increase risk
Pregnancy, cocaine use
Stanford A:
Account for 75% of dissections and involves the ascending aorta and arch proximal to the take-off of the left subclavian.
These guys need to be treated surgically.
Stanford B:
Occur distal to the take-off of the left subclavian and are treated medically unless there are complications (organ ischemia etc … )
“Cob Web Sign”
slender linear areas of low attenuation indicating a false lumen in aortic dissection
True lumen in aortic dissection
Continuity with undissected portion of aorta
Smaller cross sectional areas (with higher velocity blood)
Surrounded by calcifications (if present)
Usually contains the origin of coeliac trunk, SMA, and right renal artery
False lumen in aortic dissection
“cob web sign”
Larger cross section area (slower more turbulent flow)
Beak sign (acute angle at edge of lumen on axial)
Usually contains the origin of LEFT renal artery
Surrounds true lumen in Type A dissection
Intramural haematoma can occur as
- 1ry due to htn
- 2ry due to atherosclerosis, but also as focal haematoma on way to dissection
Crescent sign in aorta on non con CT
Hyperdense IMH
