Imaging modalities in children with vascular ring and pulmonary artery sling

Leonardi, Benedetta; Secinaro, Aurelio; Cutrera, Renato; Albanese, Sonia B.; Trozzi, Marilena; Franceschini, Alessio; Silvestri, Valentina; Tomà, Paolo; Carotti, Adriano; Pongiglione, Giacomo

doi:10.1002/ppul.23075

Cited by 62 publications

(52 citation statements)

References 23 publications

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“…However, compression was found in Patients 3,4,6,7,8,9, and 11. In these patients, the dilated pulmonary artery had approached the chest wall and caused the bronchial Figure 1.…”

Section: Resultsmentioning

confidence: 92%

“…AC commonly occurs in patients with anomalies of the aortic arch system and vascular rings (1), and it has been known to cause extrinsic airway malacia (6). The most common anomalies associated with AC in children are those of the vascular rings; rarely reported causes of AC include left-to-right shunt (causing dilatation of the pulmonary arteries), truncus arteriosus, tetralogy of Fallot (in the absence of a pulmonary valve), and malpositioned or dilated aorta (1,7,8). The most frequently compressed airway structures are the trachea and the main bronchus.…”

Section: Introductionmentioning

confidence: 99%

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Unknown vascular compression of the airway in patients with congenitalheart disease and persistent lower respiratory symptoms

T¹,

Aslan²,

Öztunalı³

et al. 2017

Turk J Med Sci

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Background/aim: Airway compression (AC) by vascular structures is an important complication of congenital heart disease (CHD) that often goes unrecognized. It is not easy to identify whether CHD patients require additional invasive examinations or not. Therefore, the present study aims to develop an AC diagnostic algorithm for CHD patients.Materials and methods: CHD patients with persistent respiratory symptoms that were treated between January 2007 and December 2015 were retrospectively reviewed. The following data were recorded for all CHD patients with AC: age, cardiac anomalies, the compressed structure, the airway diameter ratio (ADR), the compressing structure(s), treatment, and follow-up.Results: During the 8-year study period, 62 of 253 CHD patients had persistent respiratory symptoms, of which 11 cases were diagnosed as AC via bronchoscopy and/or thoracic computed tomography angiography. The most frequently affected structures were the left main bronchus and trachea, and the most common compressing structure was the right pulmonary artery. The ADR was near total compression in 3 patients and >0.50 in 3 patients. During follow-up, 5 of the 11 patients with AC underwent surgery, 2 died, and 4 were followed clinically. Patients with ADR of >0.50 did not require surgery and were followed clinically. Conclusion:CHD patients with persistent respiratory symptoms associated with lower respiratory airway obstruction should be evaluated via invasive examination. An AC diagnostic algorithm for pediatric CHD patients was developed.

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“…However, compression was found in Patients 3,4,6,7,8,9, and 11. In these patients, the dilated pulmonary artery had approached the chest wall and caused the bronchial Figure 1.…”

Section: Resultsmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Unknown vascular compression of the airway in patients with congenitalheart disease and persistent lower respiratory symptoms

T¹,

Aslan²,

Öztunalı³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…CT and MRI were shown to be equally effective in the detection of CCVM and corresponding AP in adults and older children [2,9,23,24], but discussions are still going on whether this is true also for smaller children and during infancy. One common argument of colleagues against MRI in small children is always that this method Data are given by age groups (<1 year, between 1 and 6 years, and >6 years).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, CT angiography (CTA) provides a high isotropic spatial resolution in a very short scan time and requires less radiation dose than conventional X-ray angiography (CCA) [11][12][13]. MRI is considered to be completely radiation-free, but until recently, contrast-enhanced and non-contrast-enhanced MR angiography (MRA) had the disadvantage of long scan times, thus being highly susceptible for motion artefacts [9]. However, introduction of parallel acquisition techniques increasing the temporal and/or spatial resolution significantly allowed also examinations of young children during free breathing [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Although the mentioned imaging modalities are capable of detecting the presence of CCVM, the anatomic information obtained is not precise enough for therapeutic management [4,5]. To achieve accurate characterization of the arch anatomy, cross-sectional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) is usually required [6][7][8][9]. As an additional feature post-processing methods may be used to generate 3D data from both CT and MRI giving a detailed view of the vascular morphology [10].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Suspected Vascular Rings and Slings and/or Airway Pathologies Using Magnetic Resonance Imaging Rather Than Computed Tomography

et al. 2018

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Background: Congenital cardiovascular malformations (CCVM) may cause infrequently airway pathologies (AP) in children and are of prognostic and therapeutic relevance. While computed tomography (CT) is considered first-line imaging modality in many centres, we started using magnetic resonance imaging (MRI) more and more in the last years to detect CCVM and AP to avoid radiation in this patient group. Objective: The aim of this retrospective study was to determine and to compare the diagnostic accuracy of CT and MRI when used to detect CCVM and/or AP. Methods: All patients suspected to have CCVM and/or AP and examined either by CT or MRI between 2000 and 2013 in our hospital were included. Extension and type of CCVM, as well as their relationship to esophagus, trachea or bronchi were assessed and related to findings of tracheobronchoscopy, cardiac catheterization or surgery if available. Results: One hundred six patients (median [range] 4 years [2 days to 66 years]) were examined by CT (n = 27) or MRI (n = 79). In 78 patients (74%), CCVM and/or AP were found with either of the imaging methods. CCVM were found in 63 subjects. Forty-six of 63 subjects had both, CCVM and AP. The presence of CCVM was always detected correctly by CT or MRI, although both techniques had a weakness detecting atretic segments directly. AP (n = 61) were correctly diagnosed in all patients not intubated for artificial ventilation by CT (n = 17) and in all but 2 patients by MRI (39 out of 41). Conclusions: MRI is sensitive to detect CCVM associated with AP equally to CT without any radiation exposure.

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Vascular Rings and Slings

Powell

2021

Echocardiography in Pediatric and Congenital Heart Disease

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Imaging modalities in children with vascular ring and pulmonary artery sling

Cited by 62 publications

References 23 publications

Unknown vascular compression of the airway in patients with congenitalheart disease and persistent lower respiratory symptoms

Unknown vascular compression of the airway in patients with congenitalheart disease and persistent lower respiratory symptoms

Assessment of Suspected Vascular Rings and Slings and/or Airway Pathologies Using Magnetic Resonance Imaging Rather Than Computed Tomography

Vascular Rings and Slings

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