Imaging modalities in children with vascular ring and pulmonary artery sling

Research output: Contribution to journalArticle

Abstract

Purpose Our aim is to compare new non-invasive imaging modalities in the evaluation of vascular ring (VR) and pulmonary artery sling (PAS) and to understand the role of bronchoscopy in comparison with them in assessing tracheobronchial tree. Methods We have retrospectively analyzed the data from 41 patients with a VR or a PAS diagnosed at Bambino Gesù Children's Hospital of Rome, between 2008 and 2012. Age, gender, presenting symptoms, clinical history, comorbidities, imaging modalities used for diagnosis (cardiac magnetic resonance [CMR], computed tomography [CT], tracheobronchoscopy [TB]) and surgical treatment were recorded. Results The vascular anatomy was completely defined in all patients, whether evaluated by CMR or CT, with a diagnostic accuracy of 100% based on surgical observation. All CT exams were performed without sedation with a mean dose-length product (DLP32) of 29 ± 9 and an effective dose of 1.56 ± 0.6 mSv, range 0.5-2.5 mSv. CMR required general anesthesia in all patients but involved no exposure to ionizing radiation. CT performed better than CMR in assessing tracheal stenosis when compared to TB. It detected complete tracheal cartilage rings in 2/3 patients with PAS, besides tracheomalacia and/or bronchomalacia in 54% of patients. Conclusions Both cross-sectional imaging modalities (CT and CMR) can reliably and accurately diagnose these congenital vascular anomalies. While CT involves exposure to ionizing radiation, it avoids the risks related to anesthesia needed for CMR, and provides a more accurate assessment of tracheobronchial anatomy. TB remains a fundamental tool in tracheomalacia diagnosis in VR symptomatic patients and PAS.

Original languageEnglish
Pages (from-to)781-788
Number of pages8
JournalPediatric Pulmonology
Volume50
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Pulmonary Artery
Blood Vessels
Magnetic Resonance Spectroscopy
Tomography
Tracheomalacia
Ionizing Radiation
Bronchomalacia
Anatomy
Tracheal Stenosis
Bronchoscopy
General Anesthesia
Cartilage
Comorbidity
Anesthesia
Observation

Keywords

  • cardiac magnetic resonance
  • computed tomography
  • congenital thoracic arterial anomalies
  • tracheobronchoscopy
  • vascular rings

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Imaging modalities in children with vascular ring and pulmonary artery sling. / Leonardi, Benedetta; Secinaro, Aurelio; Cutrera, Renato; Albanese, Sonia; Trozzi, Marilena; Franceschini, Alessio; Silvestri, Valentina; Tomà, Paolo; Carotti, Adriano; Pongiglione, Giacomo.

In: Pediatric Pulmonology, Vol. 50, No. 8, 01.08.2015, p. 781-788.

Research output: Contribution to journalArticle

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abstract = "Purpose Our aim is to compare new non-invasive imaging modalities in the evaluation of vascular ring (VR) and pulmonary artery sling (PAS) and to understand the role of bronchoscopy in comparison with them in assessing tracheobronchial tree. Methods We have retrospectively analyzed the data from 41 patients with a VR or a PAS diagnosed at Bambino Ges{\`u} Children's Hospital of Rome, between 2008 and 2012. Age, gender, presenting symptoms, clinical history, comorbidities, imaging modalities used for diagnosis (cardiac magnetic resonance [CMR], computed tomography [CT], tracheobronchoscopy [TB]) and surgical treatment were recorded. Results The vascular anatomy was completely defined in all patients, whether evaluated by CMR or CT, with a diagnostic accuracy of 100{\%} based on surgical observation. All CT exams were performed without sedation with a mean dose-length product (DLP32) of 29 ± 9 and an effective dose of 1.56 ± 0.6 mSv, range 0.5-2.5 mSv. CMR required general anesthesia in all patients but involved no exposure to ionizing radiation. CT performed better than CMR in assessing tracheal stenosis when compared to TB. It detected complete tracheal cartilage rings in 2/3 patients with PAS, besides tracheomalacia and/or bronchomalacia in 54{\%} of patients. Conclusions Both cross-sectional imaging modalities (CT and CMR) can reliably and accurately diagnose these congenital vascular anomalies. While CT involves exposure to ionizing radiation, it avoids the risks related to anesthesia needed for CMR, and provides a more accurate assessment of tracheobronchial anatomy. TB remains a fundamental tool in tracheomalacia diagnosis in VR symptomatic patients and PAS.",
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author = "Benedetta Leonardi and Aurelio Secinaro and Renato Cutrera and Sonia Albanese and Marilena Trozzi and Alessio Franceschini and Valentina Silvestri and Paolo Tom{\`a} and Adriano Carotti and Giacomo Pongiglione",
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AU - Secinaro, Aurelio

AU - Cutrera, Renato

AU - Albanese, Sonia

AU - Trozzi, Marilena

AU - Franceschini, Alessio

AU - Silvestri, Valentina

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AU - Carotti, Adriano

AU - Pongiglione, Giacomo

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