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Reffo Elena, Cavaliere Annachiara, Di Salvo Giovanni, ‘Spike-and-dome’ pattern in phase-contrast magnetic resonance imaging of the diaphragmatic aorta, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 9, September 2020, Page 1051, https://doi.org/10.1093/ehjci/jeaa112
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Extract
A 10-year-old girl with recently diagnosed severe hypertension (140/80 mmHg) was referred to our Institution for cardiologic evaluation. No relevant past clinical history nor familiar history of hypertension, cardiomyopathies, or sudden death were reported.
The only remarkable clinical findings were bilaterally decreased femoral pulses.
The transthoracic echocardiographic evaluation showed normal left ventricular volumes and systolic function, no myocardial hypertrophy, and no valvular malfunction. No isthmal coarctation was detected. Pulsed-wave (PW) Doppler interrogation of the descending thoracic aorta was difficult due to inadequate subxifoid acoustic window, however, prolonged dyastolic phase was noticed.
Therefore, magnetic resonance imaging (MRI) examination of the aorta was performed, showing a normal left aortic arch (Panels A and B). Phase-contrast sequence obtained at diaphragmatic aorta demonstrated a pathologic flow pattern, resembling the ‘spike-and-dome’ appearance, already described as a PW-Doppler pattern in patients with obstructive pathology of the abdominal aorta (Panel C; Panel D shows a normal aortic flow pattern).
