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Angeborene Fehlbildungen der Aorta im Kindes- und Jugendalter

Congenital abnormalities of the aorta in children and adolescents

  • Leitthema: Aorta
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Zusammenfassung

Fehlbildungen der Aorta gehören zu den häufigen kongenitalen kardiovaskulären Malformationen (15–20% aller angeborenen Herzfehler). Die räumlich und zeitlich hochauflösenden Methoden der Computer- (CT-) und Magnetresonanztomographie (MRT) sind nichtinvasive, hochwertige und aussagekräftige Methoden zur Diagnostik angeborener Fehlbildungen der Aorta. Sie zeigen sich in der Diagnostik der Gefäßanomalien gleichwertig zur konventionellen Angiographie mit Sensitivitäten von mehr als 90%. In der Diagnostik assoziierter Komplikationen, wie trachealen, bronchialen oder ösophagialen Kompressionen, sind sie überlegen. Es konnte gezeigt werden, dass 80% der Kleinkinder mit Fehlbildungen der Aorta einen direkten Vorteil von der nichtinvasiven Bildgebung hatten: Entweder war eine Herzkatheterung für die Therapieplanung nicht mehr erforderlich oder die Durchleuchtungs- und Narkosezeiten bei der Katheterintervention konnten deutlich verkürzt werden.

Die wichtigsten angeborenen Fehlbildungen der Aorta im Kindes- und Jugendalter werden exemplarisch vorgestellt sowie die Möglichkeiten der CT und MRT zur Diagnostik.

Abstract

Aortic abnormalities are common cardiovascular malformations accounting for 15–20% of all congenital heart disease. Ultrafast CT and MR imaging are noninvasive, accurate and robust techniques that can be used in the diagnosis of aortic malformations. While their sensitivity in detecting vascular abnormalities seems to be as good as that of conventional catheter angiocardiography, at over 90%, they are superior in the diagnosis of potentially life-threatening complications, such as tracheal, bronchial, or esophageal compression. It has been shown that more than 80% of small children with aortic abnormalities benefit directly from the use of noninvasive imaging: either cardiac catheterization is no longer necessary or radiation doses and periods of general anesthesia for interventional catheterization procedures can be much reduced.

The most important congenital abnormalities of the aorta in children and adolescents are presented with reference to examples, and the value of CT and MR angiography is documented.

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Authors and Affiliations

  1. Abt. Pädiatrische Kardiologie, Universitätskinderklinik Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg, Deutschland

    J.G. Eichhorn

  2. Abt. Radiologie, Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Heidelberg, Deutschland

    S. Ley

  3. Abt. Pädiatrische Radiologie, Radiologische Universitätsklinik Heidelberg, Heidelberg, Deutschland

    S. Ley

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Correspondence to J.G. Eichhorn.

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Eichhorn, J., Ley, S. Angeborene Fehlbildungen der Aorta im Kindes- und Jugendalter. Radiologe 47, 974–981 (2007). https://doi.org/10.1007/s00117-007-1575-8

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