A New Diagnostic Approach to Vascular Rings and Pulmonary Slings: The Role of MRI

Beekman, R. P.; Hazekamp, Mark G.; Sobotka, M.A.; Meijboom, Erik J.; Roos, Albert de; Staalman, C. R.; Beek, F. J. A.; Ottenkamp, Jaap

doi:10.1016/s0730-725x(97)00245-2

Cited by 45 publications

(14 citation statements)

References 26 publications

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“…Double aortic arch and pulmonary sling are considered the two leading causes of respiratory symptoms among those anomalies, forming a complete or incomplete vascular ring, respectively [2,4,5,7]. Compression to the trachea and the esophagus was noted in all three patients with a double aortic arch in our series, with accompanying respiratory symptoms in two cases.…”

Section: Discussionmentioning

confidence: 50%

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

et al. 2012

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This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and the surgical treatment of vascular rings. Data for 44 patients (32 enrolled prospectively, 12 reviewed retrospectively) over a 10-year period in a tertiary referral center were analyzed. These patients comprised 25 patients with a left aortic arch and an aberrant right subclavian artery, 13 patients with a right aortic arch and a left subclavian artery originating from Kommerell’s diverticulum, 1 patient with a right aortic arch and an aberrant left subclavian artery, 3 patients with a double aortic arch, and 2 patients with a pulmonary sling. Respiratory symptoms were found in 25 patients and dysphagia in 6 patients. Atypical symptoms such as reflex apnea, cyanosis, syncope episodes, and exercise-induced wheezing were noted in five patients. Associated congenital heart defects were detected in 41% of the patients. The diagnostic yield was 95.23% for barium esophagography, 54.54% for echocardiography, and 66.66% for computed tomography. The anatomy could be correctly identified by magnetic resonance imaging (MRI) in 97.43% and by angiography in 90.5% of the patients. Of the 30 patients who underwent surgery, 80% were completely relieved of symptoms during a mean follow-up period of 25 ± 33.5 months. Vascular rings should not be overlooked in infants with atypical symptoms. The authors’ diagnostic procedure of choice is MRI because it is superior to angiography for delineating the relationship between abnormal vascular structures, trachea, and esophagus.

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Section: Discussionmentioning

confidence: 50%

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

et al. 2012

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“…6 Magnetic resonance imaging provides good images of mediastinal structures and vascular anatomy without radiation. 8 Flexible bronchoscopy is useful in certain cases where early imaging has been unhelpful 9 and can optimize preoperative assessment in the detection of associated tracheobronchial anomalies. 2 In the case of the infant presented, flexible bronchoscopy performed via the ETT was a relatively easy procedure leading to a significant finding that allowed immediate relief of the airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

Double aortic arch presenting as severe bronchiolitis in a 2‐week‐old infant

Griffiths

Massie

South

2005

J Paediatrics Child Health

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A 2-week-old female infant was transferred from a regional hospital for mechanical ventilation after developing severe respiratory distress. Stridor had been present since the age of 1 week and was complicated by coryzal illness. Mechanical ventilation was difficult with marked inspiratory and expiratory flow obstruction recorded by the ventilator. Echocardiogram showed a normal heart. Flexible bronchoscopy revealed mid-tracheal extrinsic compression (unchanged with positive end-expiratory pressure) and advancement of the endotracheal tube by 2 cm completely corrected the flow obstruction. Repeat echocardiogram showed a double aortic arch. This case report emphasizes the importance of clinical history, examination findings and interpretation of the ventilator waveforms in the differential diagnosis of a difficult-to-ventilate infant with bronchiolitis.

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“…Anomalies of the aortic arch are due to failure of fusion and regression of the brachial arches in a usual manner during the embryologic development of the aortic arch, pulmonary arteries and ductus arteriosus [78,79]. The diagnosis of these abnormalities using CMR can be achieved by contrast enhanced (CE-MRA) and non-contrast enhanced 3D SSFP sequences, which delineate the anatomy very well, [80] and can often depict associated airway anomalies.…”

Section: Clinical Applicationsmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance in Pediatric Congenital Heart Disease

Ntsinjana

Hughes

2011

Journal of Cardiovascular Magnetic Resonance

137

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Cardiovascular magnetic resonance (CMR) has expanded its role in the diagnosis and management of congenital heart disease (CHD) and acquired heart disease in pediatric patients. Ongoing technological advancements in both data acquisition and data presentation have enabled CMR to be integrated into clinical practice with increasing understanding of the advantages and limitations of the technique by pediatric cardiologists and congenital heart surgeons. Importantly, the combination of exquisite 3D anatomy with physiological data enables CMR to provide a unique perspective for the management of many patients with CHD. Imaging small children with CHD is challenging, and in this article we will review the technical adjustments, imaging protocols and application of CMR in the pediatric population.

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A New Diagnostic Approach to Vascular Rings and Pulmonary Slings: The Role of MRI

Cited by 45 publications

References 26 publications

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

Double aortic arch presenting as severe bronchiolitis in a 2‐week‐old infant

The Role of Cardiovascular Magnetic Resonance in Pediatric Congenital Heart Disease

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