[Evaluation of airway obstruction compressed by thoracic great vessels or their branches using multi-slice helical...

Airway obstruction due to compression by the thoracic great vessels or their branches sometimes appears in patients with congenital heart disease. However, to make a definitive diagnosis may not be easy, because respiratory symptoms are common and stem from a variety of causes in this cohort. Thus, some invasive evaluation, including angiography, bronchial fiberscopy, and bronchography has usually been required. We employed multi-slice helical computed tomography (MSCT) and 3-dimensional (3D) image reconstruction in 7 cases (median age, 107 days ; range, 21 days to 6 years) who were suspected of complicating external vascular compression as a cause of respiratory symptoms. The CT scan clearly showed detailed anatomy of the thoracic vessels and interrelationship with the airway systems. It also disclosed a culprit artery compressing the trachea or bronchus. Different from other invasive or noninvasive examination modalities, MSCT allows precise evaluation of 2 independent organ systems, such as vascular and respiratory systems. We conclude that MSCT with 3D image reconstruction represents a reliable less-invasive technique for assessment of symptomatic airway obstruction caused by vascular compression.