Right aortic arch with mirror-image branching in an asymptomatic adult: A rare case demonstrated with 64-detector computed tomography

We report an asymptomic 48-year-old woman presenting with a right aortic arch (RAA) with mirror-image branching, combined an aortic diverticulum and engorged azygos vein. Chest X-ray (CXR) showed soft tissue opacity over the right paratracheal region with absence of a left aortic notch. Computer tomography (CT) was performed for further evaluation. Three-dimensional CT angiography reconstruction portrayed the above mentioned findings. When A right aortic arch with mirror-image branching was found, it usually is associated with severe congenital heart disease. Here, we report this case with an atypical clinical presentation and image findings demonstrated by three-dimensional CT angiography.