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CT Aorta

Technique: Helical CT scanning was performed from the top of the aortic arch to the level of the diaphragm with sagittal and coronal reformations. IV contrast was administered. 5mm noncontrast axial images were obtained with coronal and sagittal reconstructions. 1.25 axial images with contrast were obtained. Findings: Atherosclerotic vascular calcifications are seen throughout the tortuous aorta and its major branches. There are also cardiac valvular and coronary artery calcifications. There is no evidence of intimal flap or filling defect in the aortic arch branches or within aorta. Descending aorta aneurysm measuring 4.8 cm in AP diameter (Series 5, Iimage 157), previously 4.7 cm is unchanged from prior. There is persistent soft tissue plaque with areas of ulceration. Liver demonstrate several circumscribed hypodensities too small to characterize. A single calcification is noted within the gallbladder. Pancreas is atrophic and demonstrate multiple punctate calcifications. The spleen is unremarkable. There is left adrenal hypodense lesion unchanged from prior. Left-sided renal exophytic fluid density lesion is noted. There is also right-sided interpolar cyst. Visualized bowel demonstrates no bowel wall thickening. Moderate degenerative changes of thoracic spine are noted. The visualized lungs demonstrate no mass, consolidation or pleural effusion. Emphysematous changes are noted. There is no pneumothorax. IMPRESSION: 1. No evidence of aortic or aortic arch branch dissection as queried. 2. Unchanged descending aorta aneurysm with soft tissue plaque ulceration. 3. Chronic stable changes as above. ---------------------------------------------------------------------------------------------- Findings: The aorta is of largest caliber in the descending portion and aortic arch measuring approximately 3.5 centimeters in caliber. Atherosclerotic calcifications are noted throughout the ascending aorta, aortic arch, descending aorta and its branches. The lungs demonstrate bibasilar subsegmental atelectatic or fibrotic changes. The heart is normal in size. There are cardiac valvular and coronary artery atherosclerotic calcifications. There is no pleural or pericardial effusion. There is no mediastinal lymphadenopathy. There is no pneumothorax. The liver, spleen, adrenal glands and pancreas have an unremarkable noncontrast CT appearance. There is mild bilateral renal atrophy worse on the left most likely secondary to a large atherosclerotic plaque in the ostium of the left renal artery. There is a small calcification in the renal pelvis, which may be vascular or a nonobstructing calyceal nephroliths. There is no other renal calcification. There is no hydronephrosis. There is a small exophytic cyst lesion in the upper pole of the right kidney, unchanged since the comparison study, which is most likely a cyst. The visualized unopacified bowel loops are unremarkable. There is no free intraperitoneal air. There are mild compression deformities of the T12 and L1 vertebra, which are of uncertain age. Multilevel degenerative disease of thoracolumbar spine with a right apex midlumbar scoliosis are again noted. IMPRESSION: 1. No aortic aneurysm. 2. Atherosclerotic vascular disease. 3. Mild compression deformities of the T12 and L1 vertebra, and pronounced multilevel degenerative disease of the thoracolumbar spine with right apex midlumbar scoliosis. --------------------------------------------------------------------------------------------- Technique: Helical CT of the thoracic aorta was performed without contrast following the uneventful administration of IV contrast during the arterial phase, acquiring coronal and sagittal reformations of the arterial enhanced phase. Findings: The aorta demonstrates mild ectasia of its ascending thoracic segment, measuring up to 3.8 cm. There is no rupture, aneurysm, plaque ulcer, or penetrating ulcer. There is no filling defect within the aorta or pulmonary vasculature. The lungs demonstrate very mild dependent basilar atelectasis, otherwise there is no airspace consolidation. 6 mm pleural based left upper lobe pulmonary nodule is noted. Calcified right upper lobe pulmonary nodules also identified. The upper abdominal viscera are unremarkable. The skeleton demonstrates flowing anterior osteophytes of the thoracic spine with scattered endplate degenerative change. Impression: 1. Mild ectasia of the ascending thoracic aorta without evidence of aneurysm, rupture, filling defect, plaque ulcer, or penetrating ulcer. 2. 6 mm left upper lobe pleural-based pulmonary nodule. Correlate with risk factors for malignancy. According to recent Fleischner criteria, if the patient is low risk, a followup CT scan in 12 months is advised. If the patient is high risk, a followup in 6 to 12 months is suggested. ---------------------------------------------------------------------------------------------