Purpose or Case Report: To review and present the MDCT angiography features of the congenital aortic anomalies in a comprehensive manner with supplemental description of their association to the adjacent airway and/or esophageal structures.

Congenital thoracic aortic anomalies manifest in a wide array of imaging presentations that are enumerated in this pictorial review. Multidetector CT (MDCT) angiography in reformatted and 3D images provides noninvasive technique to visualize the aortic anomalies, in addition to assessment of the airways and esophagus.

MDCT provides comprehensive non-invasive imaging of the congenital thoracic aortic anomalies as follows:
A. Vascular Ring. This is an anomalous formation of vessels that may completely or incompletely encircle the trachea and esophagus with potential of causing airway and/or esophageal compromise [1]. Anomalies included are the left aortic arch with aberrant right subclavian artery (the most common congenital aortic arch anomaly that commonly clinically cause dysphagia lusoria), the right aortic arch with mirror-image branching (the second most common type of arch anomaly), and the double aortic arch (the most common cause of symptomatic vascular ring).

B. Interrupted Aortic Arch. Major characteristics is complete discontinuity of aortic lumen between the ascending and the descending aorta. There are three (3) types in this pictorial review: Type A- aortic interruption between the left subclavian artery and descending aorta, Type B- aortic interruption between the left subclavian artery and the left common carotid artery, and Type C- aortic interruption between the left common carotid artery and the innominate artery.

C. Coarctation of the Aorta. Focal narrowing of the aortic lumen which is located at the level of the isthmus in majority of cases. This has two classifications which are the preductal form and the other the postductal form.

Congenital anomalies of the thoracic aorta comes in many forms. MDCT has advantages of ultra short scanning time and high spatial resolution that enables this modality to become a principal imaging method that equips Radiologists to evaluate the aortic anatomy and its congenital anomalies along with its association with the adjacent airway and esophageal structures.
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