A Pediatric Radiology textbook and Pediatric Radiology digital library
Coarctation of Aorta
Infantile / diffuse = preductal from innominate to ductus — Etiology: congenital — Imaging: long segment narrowing — Clinical: ductal dependent for collateral flow
Adult / focal = ductal / postductal — Etiology: acquired, due to rubella or neurofibromatosis type 1 in adults — CXR: 3 sign is prestenotic dilation ascending aorta / coarctation / post-stenotic dilation descenging aorta, rib notching takes 10 years due to shunting from subclavian artery -> internal thoracic artery -> intercostal arteries -> descending aorta, first 2 ribs spared because they are supplied from costocervical trunk — UGI: Reverse 3 sign is hypolastic aortic knob with dilated post stenotic segment — Clinical: most common form, presents later due to presence of collaterals
Cases of Coarctation of Aorta
CXR AP shows a 3 sign in the region of the aortic arch and bilateral rib notching.