Vascular rings in symptomatic children: frequency of chest radiographic findings.

Pickhardt, Perry J.; Siegel, M J; Gutiérrez, Fernando R.

doi:10.1148/radiology.203.2.9114098

Cited by 58 publications

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“…Synchronous airway lesions (i.e. laryngomalacia) are common findings in children with stridor and it is crucial to assess these conditions prior to surgical repair so as to avoid overlooking synchronous airway lesions that may be the true etiology of a patient's symptoms [9]. Vocal fold paresis and/or paralysis is a known complication of surgical repair of vascular ring.…”

Section: Discussionmentioning

confidence: 99%

“…A dynamic view of the airway (via bronchoscopy) would assist in the delineation between these two pathologies [7]. Pre-operative evaluation should also include frontal and lateral chest radiographs [9], barium swallow, echocardiography, and MRI or CT of the chest. The importance of frontal and lateral chest radiographs cannot be underestimated as a normal chest radiograph significantly decreases the likelihood of finding a vascular ring in a symptomatic patient [9].…”

Section: Discussionmentioning

confidence: 99%

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The presentation and management of vascular rings: An otolaryngology perspective

Shah

Mora

Bacha

et al. 2007

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The presentation and management of vascular rings: An otolaryngology perspective

Shah

Mora

Bacha

et al. 2007

International Journal of Pediatric Otorhinolaryngology

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“…A radiograph is often the initial imaging test and some abnormalities are found in almost all patients with vascular rings [5]. Arch laterality may be inferred from the anteroposterior (AP) radiograph by the pattern of indentation of the tracheal air column, which is from the right in a right arch, left in a left arch and bilateral in a double arch.…”

Section: Imaging Modalities In the Evaluation Of Vascular Ringsmentioning

confidence: 99%

Computed tomography in the evaluation of vascular rings and slings

et al. 2014

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Vascular rings are congenital abnormalities of the aortic arch-derived vascular and ligamentous structures, which encircle the trachea and oesophagus to varying degrees, resulting in respiratory or feeding difficulties in children. A sling is an abnormality of the pulmonary arterial system resulting in airway compression. Although several imaging examinations are available for the evaluation of these anomalies, computed tomography (CT) has become the preferred test because of rapid acquisitions, making it feasible to perform the study without sedation or general anaesthesia. Furthermore, CT provides excellent spatial and temporal resolution, a wide field of view, multiplanar reconstruction capabilities and simultaneous evaluation of the airway. In this review, the current role and technique of CT in the evaluation of vascular rings are discussed. A brief discussion of the embryology of the aorta and branch vessels is followed by discussion and illustration of common and some uncommon vascular rings along with critical information required by surgeons.Teaching Points• Computed tomography is valuable in the evaluation of vascular rings.• Due to variable clinical and imaging presentations, diagnosis of vascular rings is often challenging.• Laterality of the arch is critical in surgical management.

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“…8 A radiograph is often the initial imaging test and some abnormalities are found in almost all patients with vascular rings. 9 Arch laterality may be inferred from the anteroposterior (AP) radiograph by the pattern of indentation of the tracheal air column, which is from the right in a right arch, left in a left arch and bilateral in a double arch. On the lateral view, tracheal narrowing may be apparent.…”

Section: Breathing Symptoms Includementioning

confidence: 99%

Double Aortic Arch A Case Study

Afroze

Samin²

2017

Cardiovasc. j.

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Introduction:Vascular ring is a congenital anomaly in which the trachea and esophagus (or its atretic remnant) are surrounded by vessels. Vascular rings, which constitute less than 1% of congenital heart diseases, were first identified by Gross in 1945. 1 Double aortic arch is the most frequently encountered vascular ring malformation characterized by a complete encirclement of trachea and esophagus by the aortic arch. Although the double aortic arch has various forms, the common defining feature is that both the left and right aortic arches are present. 2,3 Diagnosing DAA is challenging because it has a wide clinical spectrum. Extrinsic compression of the airway by vascular rings causes respiratory symptoms and/or feeding abnormalities that usually result in prompt diagnosis during early infancy. However, there are occasions when DAA remain undiagnosed. 4 We report a case of a middle aged man with DAA which is diagnosed after doing a CT angiogram for chronic cough and dyspnea. Case presentation:Mr. J, a 40 years old male, came to OPD with the complaints of cough and breathlessness since childhood. His mother also had dust allergy, so he was given a diagnosis of bronchial asthma. Over the time treatment with salbutamol, fluticasone, montelukast failed to benefit. When he grew older he was treated for gastro-oesophageal reflux disease resulting in no benefit. He continued to have episodes of coughing triggered by cold weather and viral respiratory infections, and was diagnosed with asthma again. His physical examination was insignificant except for tachycardia. Chest auscultation revealed no abnormality. Laboratory findings were all within the normal range. Chest radiograph showed slight tracheal compression and ECG was normal. Then Echocardiography was done showing normal features. Later Chest CT scan was advised and demonstrated compression of trachea by vascular structure consistent with anomalous arch of aorta as well as some nodular shadows in both lower lobes. To confirm the diagnosis CT angiogram was performed revealing double arch of aorta with right and left arch encircling the trachea and oesophagus. Right subclavian and right common carotid arteries arise from the right arch and left subclavian and left common carotid arteries arise from the left arch. He was referred to a cardiac surgeon. Discussion:Double aortic arch is the most common symptomatic vascular ring, accounting for 50-60 % of vascular rings. 11 Developmentally it is caused by persistence of both the right and left fourth aortic arches and the right and left dorsal aortae. 12

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Vascular rings in symptomatic children: frequency of chest radiographic findings.

Abstract: A normal chest radiograph is evidence against the presence of a vascular ring in symptomatic children. Both lateral and frontal radiographs are important in diagnosis.

Cited by 58 publications

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The presentation and management of vascular rings: An otolaryngology perspective

The presentation and management of vascular rings: An otolaryngology perspective

Computed tomography in the evaluation of vascular rings and slings

Double Aortic Arch A Case Study

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Vascular rings in symptomatic children: frequency of chest radiographic findings.

Abstract: A normal chest radiograph is evidence against the presence of a vascular ring in symptomatic children. Both lateral and frontal radiographs are important in diagnosis.

Cited by 58 publications

References 0 publications

The presentation and management of vascular rings: An otolaryngology perspective

The presentation and management of vascular rings: An otolaryngology perspective

Computed tomography in the evaluation of vascular rings and slings

Double Aortic Arch  A Case Study

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Double Aortic Arch A Case Study