Abstract
Time-resolved, 3D, phase-contrast magnetic resonance imaging (4D flow) is an effective means of evaluating dynamic multidirectional blood flow in the thoracic aorta.1 We have used the technique for characterization of abnormal flow features in a 14-year-old boy with aortic coarctation and bicuspid aortic valve (BAV) but without evidence of aortic stenosis or regurgitation. In addition to the expected flow disturbance in the region of the juxtaductal coarctation (Figure 1), we show an unusual flow feature in the ascending aorta that has not been previously reported in this clinical setting and that may be unique to BAV: 2 discrete nested helices of midsystolic blood flow in a nonaneurysmal aorta (Figure 2). Figure 1. Fourteen-year-old boy with BAV and aortic coarctation. A, Three-dimensional contrast-enhanced magnetic resonance angiography that demonstrates a focal juxtaductal coarctation and prominent internal mammary and …
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