The value of MRI in diagnosing vascular abnormalities causing stridor

Beekman, R. P.; Beek, F. J. A.; Hazekamp, Mark G.; Meijboom, Erik J.

doi:10.1007/s004310050651

Cited by 20 publications

(14 citation statements)

References 26 publications

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“…The branching pattern of a right aortic arch is variable. An aberrant left subclavian artery pattern is most common, coursing posterior to the esophagus and is frequently associated with a diverticulum of Kommerell ( 4 ). Mirror-image branching can rarely occur, with the right aortic arch giving off, from left to right, a left brachiocephalic artery (giving rise to the left common carotid and left subclavian artery), the right common carotid, and the right subclavian before continuing as the descending aorta ( 1 ).…”

Section: Discussionmentioning

confidence: 99%

Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant

et al. 2018

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Prenatal ultrasonography in the early third trimester showed an unusual branching pattern of the right aortic arch. Echocardiography performed 4 h after birth showed the right aortic arch with mirror-image branching, patent ductus arteriosus, and patent foramen ovale. Because the location of the ductus arteriosus was unclear on echocardiography, cardiovascular magnetic resonance imaging was performed 3 days after birth. Advanced techniques including contrast-enhanced time-resolved magnetic resonance angiography and 3D time-of-flight magnetic resonance angiography allowed accurate diagnosis of a vascular ring comprising ascending and descending aorta, right aortic arch with mirror-image branching, and diverticulum of Kommerell giving rise to a left ligamentum arteriosum. The infant had hiccups, but no other symptoms. The esophagram was negative for obstruction. The infant was closely monitored; however, she developed esophageal obstruction at 7 months of age because of the vascular ring. She underwent lysis of the left ligamentum arteriosum followed by aortopexy for relief of esophageal obstruction. This report shows the utility of neonatal cardiovascular magnetic resonance imaging to evaluate complex congenital aortic arch anomalies.

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Section: Discussionmentioning

confidence: 99%

Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant

et al. 2018

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“…8 Magnetic resonance imaging is of greatest utility for investigating the patient with a suspected vascular ring. 12 Immediate management of the compromised airway is a priority in the patient with an aspirated foreign body. In the absence of impaired gas exchange or impending airway loss, imaging is suggested.…”

Section: Visualsmentioning

confidence: 99%

Artificial Nail Aspiration Masquerading as Refractory Croup

Foskey

Singer²

2005

Pediatric Emergency Care

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Infants with an aspirated foreign body who present with acute onset of obstructed airflow should be readily diagnosed. When aspirated foreign body is overlooked, patients may present with recurrent inspiratory, biphasic, or expiratory stridor. We report an infant who repeatedly presented with varying degrees of inspiratory stridor. The diagnosis of aspirated foreign body was hampered by the presence of respiratory syncytial virus infection with the initial episode.

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“…The same image is common in patients with a right aortic arch and a left-sided arterial ligament. Magnetic resonance imaging is advocated by some as the diagnostic procedure of choice 8,13,15,20,21 instead of bronchoscopy and the oesophagram, although this view is by far not universally shared, and not advocated by the authors.…”

Section: Symptoms and Diagnostic Work-upmentioning

confidence: 99%

Vascular rings and pulmonary arterial sling: from respiratory collapse to surgical cure, with emphasis on judicious imaging in the hi-tech era

et al. 2002

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Vascularr rings, and pulmonary arterial slings, are relatively rare vascular anomalies, but are importantt lesions to recognize, since if left untreated, patients may experience life-threatening respiratoryy compromise and "near death" episodes. Surgical therapy, however, is almost alwayss curative. As most infants and children initially present with respiratory symptoms, theyy are frequently referred to and managed by pulmonologists and otorinolaryngologists beforee being presented to a surgical team. A high index of suspicion is necessary to direct thee diagnostic work-up, which may rapidly reveal the correct diagnosis, and allow for timely surgicall repair.

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The value of MRI in diagnosing vascular abnormalities causing stridor

Abstract: MRI successfully delineates the great vessels and demonstrates the presence of a vascular ring and pulmonary sling.

Cited by 20 publications

References 26 publications

Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant

Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant

Artificial Nail Aspiration Masquerading as Refractory Croup

Vascular rings and pulmonary arterial sling: from respiratory collapse to surgical cure, with emphasis on judicious imaging in the hi-tech era

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