MRI

MRI

The Common Vein Copyright 2007

Outflow Level

Aortic Valve

Normal Aortic Valve Cusps and Left Coronary Artery

This axial MRI view is shows the RVOT anterior and leftward of the aortic valve, after it has twisted around the aorta. The thin musculature of the ovoid infundibulum is in red overlay in the second image. Courtesy of Philips Medical Systems and modified by Ashley Davidoff M.D.) 32092

Valve Leaflets T1 sequence

07954bWduo heart cardiac aorta aortic valve infundibulum RVOT right ventricular outflow tract position relation MRIscan Davidoff MD

D Transposition

07258b02 anterior aorta posterior pulmonary artery position connection subaortic conus D TGA TGV D transposition of the great vessels D transposition of the great arteries dextro rightward MRI Davidoff MD

Sinus of Valsalva Aneurysm

07974c01 heart cardiac right atrium aortic valve aortic sinus fx right atrial filling defect dx sinus of Valsalva aneurysm of the right aortic sinusprolapsing into the right atrium (RA defect) dx Marfan’s Syndrome MRI T1 weighted Davidoff MD 07973.800 07974c01 07974.800

Supravalvar Aortic Stenosis

Hx 4 year female with cocktail pesonality hearyt cardiac artery aorta supravalvular aortic stenosis supravalvar aortic stenosis Williams syndrome William’s syndrome

08233b01

Truncus Arteriosus

01651.800 aorta pulmonary arteries branch pulmonary artery fx origin of the branch PA fromthe posterior aspect of the aorta dx TA truncus arteriosus MRI T1 weighted CHD

Isthmus

Coarctation

This combination of an angiogram and MRI show a focal coarctation of the aorta distal to the dilated left subclavian artery. Note the large internal mmammary artery in the angiogram (a) Courtesy Ashley Davidoff MD 00254c02 code CVS aorta thorax coarctation

Arch and Descending

Tortuos Thoracic Aorta

38852.800 thorax abdomen ascending aorta aortic arch descending thoracic aorta abdominal aorta shape tortuous MRI Courtesy Ashley Davidoff MD

Aortic Dissection – Angiography and MRI

The thoracic angiogram (a,b)reveals an aortic dissection which starts just after the left subclavian artery. The true lumen is the narrowed medial lumen which is denser than the larger lateral false lumen. In (c) the A-P view reveals a patent proximal abdominal aorta, but the distal narrowing and occlusion of the the left iliac artery suggests that the dissection has progressed downstream. In the cross sectional MRI images (d,e,f,g) the intimal flap separating the true and false lumena is quite obvious. The true lumen is medial and narrow while the false is lateral and larger. Note that the SMA in g, arises off the smaller true lumen. In image h, a coronal view of the aorta, reveals the true narrow lumen anteriorly with faster (more intense) flow, and the posterior larger lumen with slower flow. Courtesy Laura Feldman MD. 35124c code CVS artery aorta dissection thorax abdomen angiography MRI

Abdominal Aorta

MRI vs CT for AAA

These two images represent cross sectional imaging of an infrarenal fusiform abdominal aortic aneurysm, with image a, being from a T1 weighted MRI sequence and image b from a CT scan with contrast. MRI fails to have the sensitivity for calcium that CT does, and since calcification is an intrinsic part of aneurysmal disease, when it comes to meausurement of aortic aneurysmal size, CT is superior. Courtesy Ashley Davidoff MD 15153c02 code CVS aorta abdomen AAA aneurysm fusiform infrarenal

AAA

23263b back pain aorta artery abdominal aortic aneursym fusiform shape spine bone MRI T1 sagittal Courtesy James Donnelly MD

Aortic Occlusion

14646.800 aorta kidney artery superior mesenteric artery arc of Drummond IMA inferior mesenteric artery collaterals renovascular disease occluded aorta internal iliac artery fx occluded occlusion small compensatory hypertrophy collaterals MRA MRIscan Davidoff MD

Takayasu’s Arteritis

16910b aorta thorax fx irregular fx narrow dx Takayasu arteritis imaging radiology MRI Courtesy Ashley Davidoff MD DB