Images in cardiovascular medicine. Time-resolved 3-dimensional magnetic resonance velocity mapping at 3 T reveals drastic changes in flow patterns in a partially thrombosed aortic arch.

A 36-year-old female patient presented with recurrent arterial emboli of both arms and a suspected transient ischemic attack. Routine thoracic contrast-enhanced, 3D magnetic resonance angiography (CE-MRA) at 3 T was performed to rule out additional arterial thrombi. The resulting CE-MRA images and consecutive, curved, multiplanar reconstructions (Figure 1B and 1C) revealed a partially obstructing thrombus (as a signal void in the otherwise-bright aortic lumen) in the aortic arch and the proximal left subclavian artery. In contrast, maximum-intensity-projection analysis (Figure 1A) did not depict these findings, which mimicked normal aortic geometry. Figure 1. A, Inconspicuous CE maximum-intensity projection of MRA at 3-T field strength. No obvious cause for the concomitant …