Post-operative imaging of pulmonary vessels

Restrepo, Carlos S.; Vargas, Daniel; Martínez-Jiménez, Santiago; Ocazionez, Daniel

doi:10.21037/cdt.2018.03.03

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…Vascular complications after cardiothoracic surgery include pulmonary artery thrombosis, pseudoaneurysm, pulmonary vein thrombosis, vascular fistulas, stenosis, and infarction. MDCT is often the imaging modality of choice to visualize the entire cardiothoracic vasculature, airways, lung parenchyma, and mediastinum [35]. In our study, patients with pulmonary and tricuspid atresia, post-Glenn surgery, on aspirin, developed marked RV hypertrophy with a fistula between RV cavity and right coronary artery.…”

Section: Discussionmentioning

confidence: 62%

MDCT angiographic findings of various congenital pulmonary artery anomalies in pediatric patients

Harraz

Abou-Issa

Saleh

et al. 2019

Egypt J Radiol Nucl Med

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Background: Congenital pulmonary artery anomalies are variable and need proper diagnosis and treatment. CT angiography with multiplanar reconstruction has the main role in the assessment of these anomalies and this noninvasive method should be the method of choice for preoperative planning and postoperative follow up. The aim of the study is to assess the value of MDCT in the detection of pulmonary arteries anomalies in the pediatric population with complex congenital heart disease in conjunction with echocardiography as an alternative to conventional angiography and to determine the superiority of MDCT in the assessment of other abnormalities such as airway anomalies. Results: In our retrospective study, 52 patients (28 male and 24 females, aged 1 day to 4 years: mean age 2 years) were examined with contrast-enhanced CT. CT examinations were done using a 128-section CT scanner (Siemens Somatom Definition AS) using non-ionic iodinated contrast media. 2D and 3D reconstructions were performed. The correlation was made with echocardiograms. All imaging studies were reviewed. The echo was done to all patients. Surgery and/or catheter angiography performed to all patients, their findings were reviewed and compared to CTA findings. Other abnormalities such as congenital airway anomalies are detected using axial MDCT images and reconstructed imaging techniques. MDCT was accurate in revealing pulmonary artery anomalies. The commonest pulmonary artery anomaly was atresia, stenosis then hypoplasia. These anomalies may be isolated or associated with other congenital heart diseases. In the current study, MDCT could diagnose all cases of pulmonary arterial anomalies with 96% sensitivity, 100% specificity, 98% accuracy, 100% positive, and 94% negative predictive values. CT scans provide accurate information to assess complex spatial relationships of vascular airway compression frequently associated with CHD in the pediatric population. Conclusion: MDCT scanner can be an alternative to diagnostic conventional angiography for the non-invasive assessment of the pulmonary artery. Higher quality multiplanar and 3D reconstruction achieved by the MDCT scanners offer a rapid, reliable and non-invasive technique that can be used for the evaluation and preoperative assessment of thoracic vascular and extra-vascular anatomy in infants and children with suspected congenital heart disease. CT technologies are constantly developing collaboration between radiologists, pediatric cardiologists, and anesthesiologists, which is essential for improving CT performance.

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Section: Discussionmentioning

confidence: 62%

MDCT angiographic findings of various congenital pulmonary artery anomalies in pediatric patients

Harraz

Abou-Issa

Saleh

et al. 2019

Egypt J Radiol Nucl Med

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“…Both primary and secondary PVS are characterized by an abnormal proliferation of myofibroblast-like cells [9,10]. In both children and adults, non-invasive imaging, particularly multidetector CT (MDCT), which can visualize the decreased luminal caliber of the affected pulmonary vein(s), is important for the initial diagnosis and follow-up evaluation of PVS after treatment [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Pleuropulmonary MDCT Findings: Comparison between Children with Pulmonary Vein Stenosis and Prematurity-Related Lung Disease

et al. 2022

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Purpose: To retrospectively compare the pleuropulmonary MDCT findings in children with pulmonary vein stenosis (PVS) and prematurity-related lung disease (PLD). Materials and Methods: All consecutive infants and young children (≤18 years old) who underwent thoracic MDCT studies from July 2004 to November 2021 were categorized into two groups—children with PVS (Group 1) and children with PLD without PVS (Group 2). Two pediatric radiologists independently evaluated thoracic MDCT studies for the presence of pleuropulmonary abnormalities as follows—(1) in the lung (ground-glass opacity (GGO), triangular/linear plaque-like opacity (TLO), consolidation, nodule, mass, cyst(s), interlobular septal thickening, and fibrosis); (2) in the airway (bronchial wall thickening and bronchiectasis); and (3) in the pleura (thickening, effusion, and pneumothorax). Interobserver agreement between the two reviewers was evaluated with the Kappa statistic. Results: There were a total of 103 pediatric patients (60 males (58.3%) and 43 females (41.7%); mean age, 1.7 years; range, 2 days–7 years). Among these 103 patients, 49 patients (47.6%) comprised Group 1 and the remaining 54 patients (52.4%) comprised Group 2. In Group 1, the observed pleuropulmonary MDCT abnormalities were—pleural thickening (44/49; 90%), GGO (39/49; 80%), septal thickening (39/49; 80%), consolidation (4/49; 8%), and pleural effusion (1/49; 2%). The pleuropulmonary MDCT abnormalities seen in Group 2 were—GGO (45/54; 83%), TLO (43/54; 80%), bronchial wall thickening (33/54; 61%), bronchiectasis (30/54; 56%), cyst(s) (5/54; 9%), pleural thickening (2/54; 4%), and pleural effusion (2/54; 4%). Septal thickening and pleural thickening were significantly more common in pediatric patients with PVS (Group 1) (p < 0.001). TLO, bronchial wall thickening, and bronchiectasis were significantly more frequent in pediatric patients with PLD without PVS (Group 2) (p < 0.001). There was high interobserver kappa agreement between the two independent reviewers for detecting pleuropulmonary abnormalities on thoracic MDCT angiography studies (k = 0.99). Conclusion: Pleuropulmonary abnormalities seen on thoracic MDCT can be helpful for distinguishing PVS from PLD in children. Specifically, the presence of septal thickening and pleural thickening raises the possibility of PVS, whereas the presence of TLO, bronchial wall thickening and bronchiectasis suggests PLD in the pediatric population.

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