Vascular rings: 10-year review of imaging

Radiologic studies of 47 children with surgically proved vascular rings were retrospectively reviewed. On radiographs, a right-sided or bilateral aortic arch and the presence of tracheal narrowing were signs indicative of vascular rings. On barium esophagograms, a double or right aortic arch appeared as deep persistent posterior indentation of the esophagus. On computed tomographic (CT) scans and magnetic resonance (MR) images, the diagnosis of vascular rings was based on vascular branching patterns, the side of the aortic arch or presence of two arches, and narrowing of the airway. Although the diagnosis of a complete vascular ring can usually be established with certainty by means of radiography and esophagography, CT and MR imaging add valuable anatomic detail about exact arch configuration, tracheobronchial compression, and brachiocephalic vessel branching.