Aortic pseudocoarctation is an uncommon congenital abnormality of the thoracic aorta. Characterized by an elongation of the first descending part of the aortic arch, an abnormal kinking at the level of the ligamentum arteriosum can be observed (Fig. 7). It occurs when the third and seventh aortic dorsal segments fail to fuse properly to form the aortic arch. A degree of stenosis may be present due to the aortic kinking, although pressure gradients are typically not detected .
MRI is an effective tool in the workup of this abnormality. On spin-echo images the high anatomic position of the aortic arch and kinking of the proximal descending aorta can be identified clearly.Velocity encoded imaging is helpful for the exclusion of relevant pressure gradients. Due to turbulent flow phenomena caused by the tortuous course of the vessel a region of flow void may be detected in aortic pseudocoarctation, however this should not be confused with aortic stenosis or coarctation. On 3D MR angiography the complete anatomic course of the descending aorta can be depicted and the absence of collateral vessels can be demonstrated .
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