Thoracic aneurysms are most commonly identified incidentally on imaging of the thorax.
They are less common compared to abdominal aortic aneurysms as the wall of the thoracic aorta is more robust
The location and shape of thoracic aortic aneurysms are variable. An aortic aneurysm, as aneurysms elsewhere, can be described as saccular or fusiform. In the case of fusiform dilatation, the term aneurysm should be applied when the diameter is >4 cm 1.
The thoracic aorta can usually be seen on both frontal and lateral chest radiographs, and aneurysms are often obvious. However, it is difficult to assess size accurately (due to magnification effects and often poor visualisation on the side of the artery).
Additionally, mediastinal masses may mimic aortic aneurysms.
Mural calcification is seen both in atherosclerotic disease as well as various causes of aortitis (see causes of ascending aorta calcification).