Chapter 12

### 1. Double aortic arch

###### Figure 12-1

Double aortic arch.

A. A lateral airway image of a 12-month-old child with stridor shows tracheal narrowing at the level of the aortic arch. There is slight anterior displacement of the trachea along the inferior aspect of the narrowed segment. The encircling vessels produce slight soft-tissue fullness (arrows). B. A sagittal reformatted CT angiography image shows the air-filled trachea and esophagus compressed between the anterior and posterior components of the vascular ring (arrows).

### 2. Double aortic arch

###### Figure 12-2

Double aortic arch.

A. There is soft-tissue density fullness adjacent to the inferior aspect of the trachea, which is greater on the right than the left (upper arrow). This segment of the trachea is poorly visualized because of anterior-posterior narrowing. The descending aorta is on the right (lower arrow). B. The lateral view shows narrowing and anterior displacement of the trachea (arrow).

### 3. Double aortic arch

###### Figure 12-3

Double aortic arch.

A. An anteroposterior esophagram image shows focal narrowing of both sides of the esophagus. The impression on the right (large arrow) is somewhat larger and more cephalad than the impression on the left. The trachea is also narrowed. The descending thoracic aorta is on the left (small arrows). B. On the lateral view, there is a prominent posterior indentation on the esophageal contrast column (arrow). The trachea is narrow.

### 4. Double aortic arch

###### Figure 12-4

Double aortic arch.

A posterior view of a CT angiography volume rendering shows the ascending aorta to branch into 2 approximately equal size aortic arches that give rise to the 4 brachiocephalic vessels. The aortic arches join posteriorly to form a normal appearing descending aorta.

### 5. Anomalous right subclavian artery

###### Figure 12-5

Anomalous right subclavian artery.

A. An anteroposterior esophagram image shows an oblique impression on the contrast column (arrow), paralleling the left main bronchus. B. The extrinsic esophageal impression is posterior on the lateral view. There is no tracheal narrowing on either projection.

### 6. Anomalous right subclavian artery

###### Figure 12-6

Anomalous right subclavian artery.

The right subclavian artery (arrow) is the last vessel to arise from the aortic arch on this posterior projection of a three-dimensional CT image.

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