RadioGraphics 2010; 30:99-110
Aliye Ozsoyoglu Bricker, MD , Bindu Avutu, BS, Tan-Lucien H. Mohammed, MD , Eric E. Williamson, MD , Imran S. Syed, MD Paul R. Julsrud, MD . Paul Schoenhagen, MD .Jacobo Kirsch, MD
Aneurysms of the Valsalva sinus (aortic sinus) can be congenital or ac¬quired and are rare. They are more common among men than women and among Asians than other ethnic groups. Nonruptured aneurysms may be asymptomatic and incidentally discovered, or they may be symptomatic and manifest acutely with mass effect on adjacent car¬diac structures. Ruptured Valsalva sinus aneurysms result in an aorto-cardiac shunt and may manifest as insidiously progressive congestive heart failure, severe acute chest pain with dyspnea, or, in extreme cases, cardiac arrest. Although both ruptured and nonruptured Valsalva sinus aneurysms may have potentially fatal complications, after treat¬ment the prognosis is excellent. Thus, prompt and accurate diagnosis is critical. Most Valsalva sinus aneurysms are diagnosed on the basis of echocardiography, with or without angiography. However, both elec-trocardiographically gated computed tomography and magnetic reso¬nance (MR) imaging can provide excellent anatomic depiction, and MR imaging can provide valuable functional information.