Pseudoprominent aorta: radiographic findings and CT correlation

Area of Science:

• Radiology
• Cardiovascular Imaging
• Thoracic Imaging

Background:

• A persistent left superior vena cava (LSVC) is a congenital anomaly where the left superior vena cava does not regress during embryonic development.
• The absence of a right superior vena cava (RSVC) is a less common variant, often associated with LSVC.
• Radiographic detection of these anomalies is crucial for clinical management.

Observation:

• A posteroanterior (PA) chest radiograph may reveal an unusually prominent ascending aorta.
• This prominence is attributed to the right upper lobe of the lung abutting and outlining the ascending aorta in the absence of the RSVC.
• This anatomical relationship enhances the visibility of the ascending aorta's profile.

Findings:

• The study presents a case where a persistent LSVC in the absence of RSVC was suspected based on PA chest radiography findings.
• The characteristic radiographic sign observed was a prominent ascending aorta.
• Computed tomography (CT) was used to confirm the diagnosis and anatomical details.

Implications:

• Recognizing this radiographic sign can aid in the early suspicion of a persistent LSVC.
• Accurate diagnosis through imaging is essential for appropriate patient care and surgical planning.
• This finding highlights the importance of detailed radiographic interpretation in congenital cardiovascular anomalies.