Multislice CT of the abdominal aorta in a patient with Takayasu’s arteritis reveals malformation of collateral arteries and occlusion of abdominal aorta

A 57 year old woman with Takayasu’s arteritis presented with abdominal discomfort. A previous enhanced computed tomography (CT) had revealed occlusion of mid portion of the abdominal aorta, but both femoral arteries had a pulse.

To evaluate the whole aorta, enhanced multislice CT (Light Speed Ultra 16, General Electric, Milwaukee, Wisconsin, USA) was performed after injection of contrast with retrospective ECG gated reconstruction with a 1.25 mm slice thickness (helical pitch 6.00) covering the cervical and thoracic areas, and non-ECG gated acquisition with a 1.25 mm slice thickness (helical pitch 13.75), that covered the abdomen and upper portion of the lower limbs. Data were transferred to a workstation (Virtual Place, Office Azemoto, Tokyo, Japan).

Axial source and coronal view of multiplanar reconstruction images revealed occlusion of the abdominal aorta with advanced calcification. Volume rendering images of the thorax revealed no abnormal findings except enlarged left and right internal thoracic arteries (LITA and RITA, respectively). The image of the abdomen and proximal portion of lower limbs revealed abnormally enlarged collateral arteries originating from enlarged inferior epigastric arteries (IEA), which continued from enlarged LITA and RITA, and deep iliac circumflex arteries (DICA). IEA and DICA fed into the distal portion of both common iliac arteries (CIA).