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Computed tomography and magnetic resonance imaging of vascular rings and other things: a pictorial review

  • Thoracic imaging
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Abstract

Compression of the airway, esophagus or both by aortic and pulmonary vessels can be caused by a variety of anatomical situations. Vascular rings are the most commonly encountered entity; however, compression can also occur from less common anomalies such as a left pulmonary artery sling or innominate artery compression. Vascular rings and other vascular compression abnormalities can be challenging to visualize and image and often require advanced imaging by CT or MRI to better understand the cause and extent of compression. Atretic vascular structures, such as the ligamentum arteriosum or atretic arch, play a key role in creating a vascular ring and do not enhance with contrast agent in a typical fashion. Despite these imaging challenges, classic and useful signs can indicate the presence or absence of a vascular ring or compression.

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References

  1. Weinberg PM (2006) Aortic arch anomalies. J Cardiovasc Magn Reson 8:633–643

    Article  Google Scholar 

  2. Weinberg PM (2012) Aortic arch and vascular anomalies. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF (eds) Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, 7th edn. Lippincott Williams & Wilkins, Philadelphia, pp 730–760

    Google Scholar 

  3. De Villiers JI, Nunes AJ, Elhenawy AM et al (2013) Double aortic arch presenting in an adult with dysphagia. J Card Surg 28:670–672

    Article  Google Scholar 

  4. Edwards JE (1948) Anomalies of the derivatives of the aortic arch system. Med Clin North Am 32:925–949

    Article  CAS  Google Scholar 

  5. Gould SW, Rigsby CK, Donnelly LF et al (2015) Useful signs for the assessment of vascular rings on cross-sectional imaging. Pediatr Radiol 45:2004–2016

    Article  Google Scholar 

  6. Backer CL, Mavroudis C, Rigsby CK, Holinger LD (2005) Trends in vascular ring surgery. J Thorac Cardiovasc Surg 129:1339–1347

    Article  Google Scholar 

  7. Humphrey C, Duncan K, Fletcher S (2006) Decade of experience with vascular rings at a single institution. Pediatrics 117:e903–908

  8. Hashmi SF, Hanif M, Maroo S, Pollock JCS (2009) Double aortic arch with dominant left arch and right ligamentum arteriosum. Congenit Heart Dis 4:474–477

    Article  Google Scholar 

  9. Shanmugam G, Macarthur K, Pollock J (2005) Surgical repair of double aortic arch: 16-year experience. Asian Cardiovasc Thorac Ann 13:4–10

    Article  Google Scholar 

  10. Holmes KW, Bluemke DA, Vricella LA et al (2006) Magnetic resonance imaging of a distorted left subclavian artery course: an important clue to an unusual type of double aortic arch. Pediatr Cardiol 27:316–320

    Article  CAS  Google Scholar 

  11. Kommerell B (1936) Velagerung des Ösophagus durch eine abnorm verlaufende Arteria subclavia dextra (Arteria lusoria). [Displacement of the esophagus by an abnormal right subclavian artery (Arteria lusoria)]. Fortschr Geb Roentgenstrahlen 54:590–595

  12. Vucemilo I, Harlock JA, Qadura M et al (2014) Hybrid repair of symptomatic aberrant right subclavian artery and Kommerell’s diverticulum. Ann Vasc Surg 28:411–420

    Article  Google Scholar 

  13. Woods RK, Sharp RJ, Holcomb GW 3rd et al (2001) Vascular anomalies and tracheoesophageal compression: a single institution’s 25-year experience. Ann Thorac Surg 72:434–438

    Article  CAS  Google Scholar 

  14. Backer CL, Mongé MC, Popescu AR et al (2016) Vascular rings. Semin Pediatr Surg 25:165–175

    Article  Google Scholar 

  15. Backer CL, Hillman N, Mavroudis C, Holinger LD (2002) Resection of Kommerell’s diverticulum and left subclavian artery transfer for recurrent symptoms after vascular ring division. Eur J Cardiothorac Surg 22:64–69

    Article  CAS  Google Scholar 

  16. Planché C, Lacour-Gayet F (1984) Aortic uncrossing for compressive circumflex aorta. 3 cases. Presse Med 13:1331–1332

    PubMed  Google Scholar 

  17. Xie J, Juan Y-H, Wang Q et al (2017) Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography. Sci Rep 7:40042

    Article  CAS  Google Scholar 

  18. Berdon WE, Baker DH, Wung JT et al (1984) Complete cartilage-ring tracheal stenosis associated with anomalous left pulmonary artery: the ring–sling complex. Radiology 152:57–64

    Article  CAS  Google Scholar 

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Madueme, P.C. Computed tomography and magnetic resonance imaging of vascular rings and other things: a pictorial review. Pediatr Radiol 52, 1839–1848 (2022). https://doi.org/10.1007/s00247-022-05366-y

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  • DOI: https://doi.org/10.1007/s00247-022-05366-y

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