Vascular ring: Role of multidetector CT with 3D reconstruction in diagnosis

Abstract

PurposeTo assess the role of multidetector CT (MDCT) with 3D reconstruction in the diagnosis of vascular ring. Materials and methodsWe reviewed the files of 26 patients with vascular ring abnormalities at the Pediatric Hospital, Mansoura University, between March 2009 and May 2011 who had multislice CT. Patients were examined using a 16-row CT scanner. The multislice data were transmitted to a workstation for multiplanar reconstruction (MPR) and volume rendering technique (VR) reconstruction. ResultsThere were 16 patients with double aortic arch; out of these patients, codominance was present in four patients and right dominance in 12 patients. Eight patients had right-sided aortic arch; six of them with aberrant left subclavian artery and the other two patients with mirror-image branching. Three patients with right-sided aortic arch were accompanied by other malformations (pulmonary artery stenosis in one patient, patent ductus arteriosus in one patient and left superior vena cava in one patient). Two patients had left-sided aortic arch with aberrant right subclavian. Two patients had associated Kommerell diverticulum, one with double aortic arch and the other one with right-sided aortic arch. ConclusionMDCT with 3D reconstructions is an excellent diagnostic modality in patients suspected to have a vascular ring. It not only accurately delineates the complex anatomy of these vascular structures but also allows the evaluation of possible airway compromise or esophageal impingement and provides evidences concerning the presence and location of ligamentous structures.