CTICasesRight Aortic Arch with Mirror-Image Branching and Right Ligamentum Arteriosum
Imaging findings
A non-contrast chest CT demonstrates a right-sided aortic arch with mirror-image branching. Notably, there is no diverticulum of Kommerell or medial displacement of the descending aorta. Instead, a calcified structure is seen connecting the descending aorta to the right pulmonary artery, representing a calcified right ductus diverticulum and a right ligamentum arteriosum.
Key takeaways
While a right aortic arch is commonly associated with a left-sided ligamentum arteriosum (which can form a vascular ring), a right ligamentum arteriosum is an extremely rare congenital variant. Its presence explains the absence of a left-sided ductus diverticulum and the lack of medial displacement of the descending aorta, as no vascular ring is formed.
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