Thoracic Butterfly Vertebra, Aortic Dissection

Findings:

Multiple MR images show a butterfly vertebra at the T9 level with no malalignment or vertebral body height loss. The included thoracic aorta is abnormally dilated, with evidence of dissection. The ventral true lumen demonstrates more robust flow than the partially thrombosed false lumen posteriorly.

Differential Diagnosis/Discussion:

A chronic vertebral deformity has the differential diagnosis of a remote fracture versus congenital anomaly. In this case, the symmetric appearance with central height loss and morphology indicate a congenital anomaly. This case also illustrates the importance of maintaining a search pattern of structures outside the body part that was technically imaged.

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