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Updated: Mar 26, 2026
Aortic Ring Assay
Published on: November 24, 2009
[Assessment of congenital vascular rings with MDCT on children]
Yue Zang1, Jie Zhou1, Tao Jiang1
1Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100013, China.
Insights
MDCT imaging effectively diagnoses congenital vascular rings in children, detailing their composition and relationship with the trachea and esophagus. This method aids in understanding complex cardiovascular and pulmonary malformations.
Area of Science:
- Medical Imaging
- Pediatric Cardiology
- Radiology
Background:
- Congenital vascular rings are rare but significant anomalies affecting the pediatric population.
- Accurate diagnosis is crucial for timely intervention and management of associated respiratory and cardiovascular symptoms.
- Multidetector-row computed tomography (MDCT) offers advanced visualization capabilities for complex anatomical structures.
Purpose of the Study:
- To assess the diagnostic utility of MDCT in identifying congenital vascular rings in pediatric patients.
- To evaluate the ability of MDCT to delineate the precise anatomy of vascular rings and their relationship with adjacent structures.
Main Methods:
- Retrospective analysis of 43 pediatric cases diagnosed with congenital vascular rings via MDCT.
- MDCT data were reconstructed using multiplanar reconstruction (MPR), maximum intensity projection (MIP), minimum intensity projection (MinIP), and volume rendering (VR).
- Diagnostic findings were compared with echocardiography and surgical records.
Main Results:
- MDCT successfully visualized various types of vascular rings, including pulmonary artery sling, right aortic arch with aberrant left subclavian artery, left aortic arch with aberrant right subclavian artery, and double aortic arch.
- The study identified a high incidence of coexisting cardiovascular and pulmonary malformations (93.02%), as well as tracheal stenosis in some cases.
- 3D post-processing techniques (MPR, VR, MinIP) effectively demonstrated the vascular ring components, tracheal and esophageal relationships, and associated anomalies.
Conclusions:
- MDCT, particularly with 3D post-processing, is a valuable tool for diagnosing congenital vascular rings in children.
- The technique accurately reveals the composition of vascular rings and their spatial relationship with the trachea and esophagus.
- MDCT facilitates a comprehensive understanding of associated malformations, aiding in surgical planning and patient management.
Objective:
To evaluate the value of MDCT on diagnosis of congenital vascular rings on children.
Methods:
Retrospective analysis on 43 cases of congenital vascular rings, which underwent MDCT during Oct 2008 to Dec 2014 in Beijing Anzhen hospital affiliated to capital medical university. 21 males, 22 females; age from 29 days to 8 years, mean age 1.46 years, 33 cases are not beyond 1 year. All the results were compared with that of the echocardiogram or record of the surgery. The CT data were read and reconstructed with multiplanar reconstruction (MPR), maximum intensity projection (MPR), minimum intensity projection (MinIP), volume rendering (VR). The image quality was evaluated and the diagnostic value and the standard diagnostic program were discussed.
Results:
Of 43 cases of vascular rings:there were 6 cases of pulmonary artery sling (13.95%), 9 cases of right aortic arch /aberrant left subclavian artery(20.93%), 18 cases of left aortic arch/aberrant right subclavian artery (41.86%), 10 cases of double aortic arch (23.26%). Forty cases (93.02%) were combined with other cardiovascular or pulmonary malformations. Every malformation was revealed clearly and proved by echocardiogram. Of 3 cases (6.98%) without any other malformation, 2 cases were combined tracheal stenosis. A pulmonary artery sling was proved by surgery; the other 2 cases were double aortic arch. All the images of 43 cases could be reconstructed well. MPR and VR showed the origin, shape, and whole course of vascular rings directly; MinIP and VR could display the shape, width and development of trachea, revealed the relationship between vascular rings, trachea and esophagus. It was important to show and measure the component vascular of the ring. Attention should be paid to the whole course of trachea and esophagus, especially those segments which were close to the ring vascular. The tracheal stenosis as well as intra-cardio anatomy malformations should be measured on MPR images if existed. According to the segmental analysis method, comes the overall final diagnosis. A standard diagnostic program on vascular ring was proposed.
Conclusion:
MDCT axis images with various 3D post processing methods could reveal the compose of vascular rings and the relationship between vascular rings, trachea and esophagus.
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