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Quantified evaluation of tracheal compression in pediatric complex congenital vascular ring by computed tomography
Rong Xu1, Ke Shi1, Zhi-Gang Yang2
1Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
Insights
Early diagnosis of pediatric vascular ring (VR) with congenital heart disease (CHD) is crucial. Dual-source CT effectively quantifies tracheal compression, aiding surgical decisions for VR patients.
Area of Science:
- Cardiology
- Pediatric Surgery
- Radiology
Background:
- Vascular ring (VR) associated with congenital heart disease (CHD) requires timely diagnosis and surgical intervention.
- Accurate assessment of tracheal compression is vital for successful VR repair surgery in children.
Purpose of the Study:
- To quantitatively assess tracheal compression in pediatric patients with VR and CHD using dual-source computed tomography (DSCT).
- To provide crucial information for surgical decision-making in VR cases.
- To correlate the degree of tracheal compression with symptom severity and surgical outcomes.
Main Methods:
- Quantitative measurements of tracheal dimensions (short diameter, long diameter, area, length) were performed using DSCT in 49 VR patients with CHD and 56 controls.
- The degree of tracheal compression was assessed and correlated with clinical symptoms.
- Agreement analysis was conducted for different compression ratio metrics (1-long diameter ratio, 1-short diameter ratio, 1-area ratio).
Main Results:
- A strong correlation (r=0.84) was observed between greater tracheal compression on DSCT and more severe symptoms in VR patients with CHD.
- Significant differences in tracheal compression were found between VR patients who underwent surgery and those who did not (P=0.002).
- High agreement was noted among the (1-long diameter ratio), (1-short diameter ratio), and (1-area ratio) metrics.
Conclusions:
- DSCT provides accurate quantitative data on tracheal compression in pediatric VR with CHD.
- The 1-area ratio derived from DSCT is a valuable metric for evaluating tracheal compression and may aid in VR surgical repair planning.
Abstract:
Clinically, early diagnosis and treatment is important for survival of pediatric with vascular ring (VR) associated with congenital heart disease (CHD), and accurate evaluation of VR is a prerequisite for repair surgical. The study aimed to assess the quantitative characteristics of tracheal compression in pediatrics with VR and CHD using dual-source computed tomography (DSCT), and further provided effective information for surgical decisions. A total of 49 VR patients with CHD and 56 controls were enrolled. The tracheal quantitative measurements (short diameter, long diameter, tracheal area and tracheal length) were obtained, and the degree of tracheal compression was assessed. Our results indicated that VR associated with CHD may cause more serious and complex symptoms, and the greater tracheal compression were found on DSCT when more severe symptoms were present (r = 0.84). The degree of tracheal compression was significantly different within the VR group between those with and without surgery (P = 0.002). Finally, there were good agreement among (1-long diameter ratio), (1-short diameter ratio) and (1-area ratio) in patients and controls, respectively. This study indicated that DSCT enables provides accurate quantitative tracheal compression information for VR pediatrics associated with CHD, and evaluation of the degree of tracheal compression by 1-area ratio may contribute to the repair surgical of VR.
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