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Useful signs for the assessment of vascular rings on cross-sectional imaging

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Abstract

Vascular rings can be challenging to diagnose because they can contain atretic portions not detectable with current imaging modalities. In these cases, where the compressed airway and esophagus are not encircled by patent, opacified vessels, there are useful secondary signs that should be considered and should raise suspicion for the presence of a vascular ring. These signs include a double aortic arch, the four-vessel sign, the distorted subclavian artery sign, a diverticulum of Kommerell, a ductal diverticulum contralateral to the aortic arch, and a descending aorta contralateral to the arch or circumflex aorta. If none of these findings is present, a ring can be excluded with confidence.

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Authors and Affiliations

  1. Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA

    Sharon W. Gould

  2. Medical Imaging, Ann and Robert H. Lurie Children’s Hospital, 225 East Chicago Ave., Chicago, IL, 60611, USA

    Cynthia K. Rigsby

  3. Pediatric Radiology, Texas Children’s Hospital, 6621 Fannin Street, Houston, TX, 77030, USA

    Lane F. Donnelly

  4. Medical Imaging, Nemours Children’s Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA

    Monica Epelman

  5. Pediatric Cardiology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA

    Michael McCulloch

  6. Pediatric Cardiac Surgery, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA

    Christian Pizarro

Authors
  1. Sharon W. Gould
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  2. Cynthia K. Rigsby
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  3. Lane F. Donnelly
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  4. Michael McCulloch
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  5. Christian Pizarro
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  6. Monica Epelman
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Correspondence to Sharon W. Gould.

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Gould, S.W., Rigsby, C.K., Donnelly, L.F. et al. Useful signs for the assessment of vascular rings on cross-sectional imaging. Pediatr Radiol 45, 2004–2016 (2015). https://doi.org/10.1007/s00247-015-3424-7

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  • DOI: https://doi.org/10.1007/s00247-015-3424-7

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