Abstract
Tracheobronchial anomalies are common in congenital heart disease (CHD), including tracheobronchial stenosis, tracheal bronchus, cardiac bronchus, and bronchial isomerism, which can cause varying degrees of respiratory illness. It is necessary to assess tracheobronchial anomalies and make a preoperative airway evaluation. Multi-slice computed tomography (MSCT) and cardiac magnetic resonance imaging (MRI) are the most effective noninvasive modalities for the diagnosis of CHD and the associated tracheobronchial anomalies. However, MSCT remains an ionizing procedure despite using low dose protocols. The aim of this study was to evaluate diagnostic accuracy of tracheobronchial anomalies in patients with CHD using three-dimensional turbo field echo(3D-TFE) magnetic resonance imaging sequence for preoperative airway evaluation. The results indicated that 3D-TFE provided better image quality as compared to that of 3D-balanced turbo field echo (3D-bTFE), and it can clearly demonstrated the tracheobronchial tree and tracheobronchial anomalies in CHD. This study confirms the clinical value of 3D-TFE in diagnosing tracheobronchial anomalies and supply helpful tracheobronchial information for preoperative strategies and postoperative follow-up.
Highlights
Cause of tracheobronchial stenosis Double aortic arch Right aortic arch with mirror-image branching Right aortic arch + aberrant left subclavian artery + posterior patent ductus arteriosus or ligament left aortic arch + aberrant right subclavian artery Left aortic arch with right descending aorta Innominate artery compression syndrome Left pulmonary artery sling Absent pulmonary artery valve Obvious enlarged left atrium Others Total
In 75 cases, 49 patients with tracheobronchial anomaly detected by magnetic resonance imaging (MRI) with 3D-TFE as follows: 31 cases had tracheobronchial stenosis, 9 cases had tracheal bronchus, 3 cases had bridging bronchus, 2 cases were situs inversus type of bronchus (Fig. 1a) and 4 cases were isomerism type of bronchus (3 cases were bilateral right-sided isomerism type of bronchus and 1 cases was bilateral left-sided isomerism type of bronchus) (Fig. 1b,c)
In 31 tracheobronchial stenosis cases, the predominant causes of tracheobronchial stenosis were listed in Table 1, such as double aortic arch (Fig. 2), right aortic arch with aberrant left subclavian artery (Fig. 3), left pulmonary artery sling (Fig. 4), absent pulmonary valve (Fig. 5), and enlarged left atrium (Fig. 6)
Summary
The aim of this study was to evaluate diagnostic accuracy of tracheobronchial anomalies in patients with CHD using three-dimensional turbo field echo(3D-TFE) magnetic resonance imaging sequence for preoperative airway evaluation. The aim of this study was to evaluate diagnostic accuracy of tracheobronchial anomalies in patients with CHD using 3D-TFE magnetic resonance imaging sequence for preoperative airway evaluation
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