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Gužvinec P, Muscogiuri G, Hrabak-Paar M. CT Assessment of Aortopulmonary Septal Defect: How to Approach It? J Clin Med 2024; 13:3513. [PMID: 38930042 PMCID: PMC11204932 DOI: 10.3390/jcm13123513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
An aortopulmonary septal defect or aortopulmonary window (APW) is a rare cardiovascular anomaly with direct communication between the ascending aorta and the main pulmonary artery leading to a left-to-right shunt. It is accompanied by other cardiovascular anomalies in approximately half of patients. In order to avoid irreversible sequelae, interventional or surgical treatment should be performed as soon as possible. Cardiovascular CT, as a fast, non-invasive technique with excellent spatial resolution, has an increasing role in the evaluation of patients with APW, enabling precise and detailed planning of surgical treatment of APW and associated anomalies if present. This article aims to review the anatomical and clinical features of aortopulmonary septal defect with special emphasis on its detection and characterization by a CT examination.
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Affiliation(s)
| | | | - Maja Hrabak-Paar
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- University Hospital Center Zagreb, 10000 Zagreb, Croatia
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2
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Li G, Li X, Hu J, Wang C, Lin H. Diagnosis of congenital thoracic arterial vascular rings in infants and young children using multi-slice spiral CT and MRI. Minerva Pediatr (Torino) 2024; 76:140-145. [PMID: 37449911 DOI: 10.23736/s2724-5276.23.07339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Gengwu Li
- Department of Imaging, Anhui Provincial Children's Hospital, Fudan University Anhui Hospital District, Hefei, China -
| | - Xu Li
- Department of Imaging, Anhui Provincial Children's Hospital, Fudan University Anhui Hospital District, Hefei, China
| | - Jun Hu
- Department of Imaging, Anhui Provincial Children's Hospital, Fudan University Anhui Hospital District, Hefei, China
| | - Chang Wang
- Department of Imaging, Anhui Provincial Children's Hospital, Fudan University Anhui Hospital District, Hefei, China
| | - Huihui Lin
- Department of Imaging, Anhui Provincial Children's Hospital, Fudan University Anhui Hospital District, Hefei, China
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3
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Recht HS, Weisberg EM, Fishman EK. 3D CT cinematic rendering of pediatric thoracic vascular anomalies. Eur J Radiol Open 2023; 10:100485. [PMID: 36950473 PMCID: PMC10027509 DOI: 10.1016/j.ejro.2023.100485] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
Thoracic vascular anomalies in the pediatric population are a heterogeneous group of diseases, with varied clinical presentations and imaging findings. High-resolution computed tomography is widely available and has become a standard part of the workup of these patients, often with three dimensional images. Cinematic rendering is a novel 3D visualization technique that utilizes a new, complex global lighting model to create photorealistic images with enhanced anatomic detail. The purpose of this pictorial review is to highlight the advantages of cinematic rendering compared to standard 2D computed tomography and traditional volume-rendered 3D images in the evaluation of thoracic vascular anomalies. Although cinematic rendering remains a new visualization technique under continued study, the improved anatomic detail and photorealistic quality of these images may be advantageous for surgical planning in cases of complex vascular abnormalities. Cinematic rendering may also help improve communication among clinicians, trainees, and patients and their families.
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Affiliation(s)
- Hannah S. Recht
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 800, Chicago, IL 60611, United States of America
| | - Edmund M. Weisberg
- Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, 601 North Caroline Street, Baltimore, MD 21287, United States of America
- Corresponding author.
| | - Elliot K. Fishman
- Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, 601 North Caroline Street, Baltimore, MD 21287, United States of America
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4
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Kumar P, Bhatia M, Arora N. Computed Tomographic Evaluation of Congenital Left Ventricular Outflow Obstruction. Curr Cardiol Rev 2023; 19:31-49. [PMID: 37231752 PMCID: PMC10636799 DOI: 10.2174/1573403x19666230525144602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Congenital left ventricular outflow obstruction represents a multilevel obstruction with several morphological forms. It can involve the subvalvular, valvar, or supravalvular portion of the aortic valve complex, and may coexist. Computed tomography (CT) plays an important supplementary role in the evaluation of patients with congenital LVOT obstruction. Unlike transthoracic echocardiography and cardiovascular magnetic resonance (CMR) imaging, it is not bounded by a small acoustic window, needs for anaesthesia or sedation, and metallic devices. Current generations of CT scanners with excellent spatial and temporal resolution, high pitch scanning, wide detector system, dose reduction algorithms, and advanced 3-dimensional postprocessing techniques provide a high-quality alternative to CMR or diagnostic cardiac catheterization. Radiologists performing CT in young children should be familiar with the advantages and disadvantages of CT and with the typical morphological imaging features of congenital left ventricular outflow obstruction.
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Affiliation(s)
- Parveen Kumar
- Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute, New Delhi, India
| | - Mona Bhatia
- Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute, New Delhi, India
- Convener, Cardiac Imaging, Cardiological Society of India, Kolkata, 700054, India
| | - Natisha Arora
- Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute, New Delhi, India
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5
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Eltatawy DN, Elsharawy FA, Elbarbary AA, Elsheikh RG, Badawy ME. Multi-detector computed tomography (MDCT) as a diagnostic tool in assessment of thoracic aortic anomalies in pediatric patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-020-00399-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients.
Results
Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT.
Conclusion
320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.
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6
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DADALI Y, ÖZKAÇMAZ S, DEMİR M, BURSALI İ. Mediastinal Vascular Anomalies. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.939714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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7
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Valluri A, Sitta J, Howard CM. Multifocal IgG4-related aortitis and periaortitis simulating aortic dissection. Radiol Case Rep 2021; 16:2274-2279. [PMID: 34194590 PMCID: PMC8233164 DOI: 10.1016/j.radcr.2021.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/08/2021] [Accepted: 05/08/2021] [Indexed: 11/24/2022] Open
Abstract
Immunoglobulin G4-related aortitis (IgG4-RA) is histologically characterized by the infiltration of IgG4 positive plasma cells and fibrosis in systemic organs and the elevation of serum IgG4 levels. The cardiovascular system is commonly involved with various possible presentations such as aortitis, arteritis, periaortitis, periarteritis, and inflammatory aneurysm. We present a case of a 48-year-old male without known previous medical history, admitted for further workup of long-standing chest pain and shortness of breath with suspected aortic dissection on initial assessment. Investigation with computed tomography angiography (CTA) and magnetic resonance angiography (MRA) indicated severe thoracic and abdominal aortoarteritis associated with an ascending thoracic aortic aneurysm, which was confirmed to be IgG4-RA on histopathologic analysis. Thoracic and abdominal IgG4-RA clinical and radiological presentation may simulate other causes of acute aortic syndrome such as aortic dissection, atherosclerotic aneurysm and inflammatory conditions. Accurate recognition of IgG4-RA diagnostic imaging features are essential for early diagnosis and treatment surveillance.
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Affiliation(s)
- Amrita Valluri
- Joan C. Edwards School of Medicine, Marshall University, 1 John Marshall Dr, Huntington, WV, 25755, USA
| | - Juliana Sitta
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216 USA
| | - Candace M Howard
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216 USA
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Canan A, Ashwath R, Agarwal PP, François C, Rajiah P. Multimodality Imaging of Transposition of the Great Arteries. Radiographics 2021; 41:338-360. [PMID: 33481689 DOI: 10.1148/rg.2021200069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Transposition of the great arteries (TGA) is a congenital conotruncal abnormality characterized by discordant connections between the ventricles and great arteries, with the aorta originating from the right ventricle (RV), and the pulmonary artery (PA) originating from the left ventricle (LV). The two main types of TGA are complete transposition or dextro-transposition of the great arteries (D-TGA), commonly referred to as d-loop, and congenitally corrected transposition (CCTGA), commonly referred to as l-loop or L-TGA. In D-TGA, the connections between the ventricles and atria are concordant, whereas in CCTGA they are discordant, with the left atrium connected to the RV, and the right atrium connected to the LV. D-TGA manifests during the neonatal period and can be surgically managed by atrial switch operation (AtrSO), arterial switch operation (ASO), Rastelli procedure, or Nikaidoh procedure. Arrhythmia, systemic ventricular dysfunction, baffle stenosis, and baffle leak are the common complications of AtrSO, whereas supravalvular pulmonary or branch PA stenosis, neoaortic dilatation, and coronary artery narrowing are the common complications of ASO. CCTGA may manifest late in life, even in adulthood. Surgeries for associated lesions such as tricuspid regurgitation, subpulmonic stenosis, and ventricular septal defect may be performed. A double-switch operation that includes both the atrial and arterial switch operations constitutes anatomic correction for CCTGA. Imaging plays an important role in the evaluation of TGA, both before and after surgery, for helping define the anatomy, quantify hemodynamics, and evaluate complications. Transthoracic echocardiography is the first-line imaging modality for presurgical planning in children with TGA. MRI provides comprehensive morphologic and functional information, particularly in adults after surgery. CT is performed when MRI is contraindicated or expected to generate artifacts. The authors review the imaging appearances of TGA, with a focus on pre- and postsurgical imaging. Online supplemental material is available for this article. ©RSNA, 2021.
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Affiliation(s)
- Arzu Canan
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa (R.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); and Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (C.F., P.R.)
| | - Ravi Ashwath
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa (R.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); and Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (C.F., P.R.)
| | - Prachi P Agarwal
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa (R.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); and Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (C.F., P.R.)
| | - Christopher François
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa (R.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); and Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (C.F., P.R.)
| | - Prabhakar Rajiah
- From the Department of Radiology, UT Southwestern Medical Center, Dallas, Tex (A.C.); Department of Cardiology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa (R.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); and Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (C.F., P.R.)
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Agasthi P, Pujari SH, Tseng A, Graziano JN, Marcotte F, Majdalany D, Mookadam F, Hagler DJ, Arsanjani R. Management of adults with coarctation of aorta. World J Cardiol 2020; 12:167-191. [PMID: 32547712 PMCID: PMC7284000 DOI: 10.4330/wjc.v12.i5.167] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
Coarctation of the aorta (CoA) is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose. The hallmark finding on physical examination is upper extremity hypertension, and for this reason, CoA should be considered in any young hypertensive patient, justifying measurement of lower extremity blood pressure at least once in these individuals. The presence of a significant pressure gradient between the arms and legs is highly suggestive of the diagnosis. Early diagnosis and treatment are important as long-term data consistently demonstrate that patients with CoA have a reduced life expectancy and increased risk of cardiovascular complications. Surgical repair has traditionally been the mainstay of therapy for correction, although advances in endovascular technology with covered stents or stent grafts permit nonsurgical approaches for the management of older children and adults with native CoA and complications. Persistent hypertension and vascular dysfunction can lead to an increased risk of coronary disease, which, remains the greatest cause of long-term mortality. Thus, blood pressure control and periodic reassessment with transthoracic echocardiography and three-dimensional imaging (computed tomography or cardiac magnetic resonance) for should be performed regularly as cardiovascular complications may occur decades after the intervention.
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Affiliation(s)
- Pradyumna Agasthi
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
| | - Sai Harika Pujari
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
| | - Andrew Tseng
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, United States
| | - Joseph N Graziano
- Division of Cardiology, Phoenix Children's Hospital, Children's Heart Center, Phoenix, AZ 85016, United States
| | - Francois Marcotte
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
| | - David Majdalany
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
| | - Farouk Mookadam
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
| | - Donald J Hagler
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, United States
| | - Reza Arsanjani
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
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Krupiński M, Irzyk M, Moczulski Z, Banyś R, Urbańczyk-Zawadzka M. Morphometric evaluation of aortic coarctation and collateral circulation using computed tomography in the adult population. Acta Radiol 2020; 61:605-612. [PMID: 31581781 DOI: 10.1177/0284185119877328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Analysis of morphometric details of aortic coarctation and collateral circulation using computed tomography (CT) and its impact on clinical symptoms is a perspective which is missing in the published literature. Purpose To perform CT-based qualitative and quantitative evaluation of aortic coarctation and collateral circulation with reference to clinical symptoms. Material and Methods The study comprised 2022 patients who underwent CT angiography. If aortic coarctation was seen, the patients underwent evaluation of its anatomy and associated clinical symptoms. Results Aortic coarctation was found in 33 patients. Follow-up (median 2476 days; range 1692–3543) was performed in 31 (94%) individuals. In this group (median age 42 years; range 30–52.5 years), median stenosis at the site of coarctation was 70% (range 58–85%) of the lumen area, with 17 (55%) patients presenting with significant (≥70%) stenosis. Patients with significant stenosis had a greater right and left internal mammary artery diameter ( P = 0.0070 and P = 0.0114, respectively) than those with mild stenosis. Patients with significant coarctation stenosis revealed hypertension and headache more commonly than those with mild stenosis (17 vs. 9, P = 0.01 and 10 vs. 2, P = 0.02), respectively. In patients who underwent intervention, a decrease in prevalence of hypertension (19 vs. 0, P = 0.008) and headache (12 vs. 3, P = 0.010) were observed in the follow-up. Conclusion CT enables quantitative and qualitative evaluation of aortic coarctation anatomy, including stenosis at the site of coarctation, and collateral circulation. In adult patients with aortic coarctation, the prevalence of hypertension and headache is related to the degree of stenosis at the site of coarctation and decreases after intervention.
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Affiliation(s)
- Maciej Krupiński
- Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
| | - Małgorzata Irzyk
- Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
| | - Zbigniew Moczulski
- Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
| | - Robert Banyś
- Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
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11
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Tailored Optimization of Pediatric Body MR Angiography for Successful Outcomes in Thoracic Applications. AJR Am J Roentgenol 2020; 214:1031-1041. [DOI: 10.2214/ajr.19.22253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Wang P, Jiang R. 320-slice Computed Tomography Angiography Imaging Findings and Follow-up in A Patient with Aortic Coarctation Misdiagnosed as Hypertension: A Case Report and Literature Review. Cureus 2019; 11:e6529. [PMID: 32010536 PMCID: PMC6993081 DOI: 10.7759/cureus.6529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In this case, we report a simple coarctation of the aortic isthmus (CoA) in a patient without intracardiac abnormalities or patent ductus arteriosus, who was misdiagnosed as essential hypertension for over 20 years. The patient underwent X-rays, echocardiography, and 320-slice CT angiography (CTA). Among them, CTA comprehensively showed the diameter of the aortic coarctation, the anatomy and morphology of the heart and aortic arch, and the collateral circulation before surgery. It also accurately evaluated the postoperative status of the bypass vessel. This article highlights the excellent performance of 320-slice CTA in the diagnosis, surgical planning, and follow-up in CoA. Moreover, when adolescents suffer from refractory hypertension, the possibility of organic cardiovascular disease should be considered.
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Affiliation(s)
- Peng Wang
- Department of Radiology, The General Hospital of Western Theater Command, Chengdu, CHN
| | - Rui Jiang
- Department of Radiology, The General Hospital of Western Theater Command, Chengdu, CHN
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Harraz MM, Abouissa AH, Saleh HA, Attas KA, Al-Yamani SM, Alsulami G, Refai MM. MDCT angiographic findings of various congenital pulmonary artery anomalies in pediatric patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0089-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Congenital pulmonary artery anomalies are variable and need proper diagnosis and treatment. CT angiography with multiplanar reconstruction has the main role in the assessment of these anomalies and this non-invasive method should be the method of choice for preoperative planning and postoperative follow up.
The aim of the study is to assess the value of MDCT in the detection of pulmonary arteries anomalies in the pediatric population with complex congenital heart disease in conjunction with echocardiography as an alternative to conventional angiography and to determine the superiority of MDCT in the assessment of other abnormalities such as airway anomalies.
Results
In our retrospective study, 52 patients (28 male and 24 females, aged 1 day to 4 years: mean age 2 years) were examined with contrast-enhanced CT. CT examinations were done using a 128-section CT scanner (Siemens Somatom Definition AS) using non-ionic iodinated contrast media. 2D and 3D reconstructions were performed. The correlation was made with echocardiograms. All imaging studies were reviewed. The echo was done to all patients. Surgery and/or catheter angiography performed to all patients, their findings were reviewed and compared to CTA findings. Other abnormalities such as congenital airway anomalies are detected using axial MDCT images and reconstructed imaging techniques.
MDCT was accurate in revealing pulmonary artery anomalies. The commonest pulmonary artery anomaly was atresia, stenosis then hypoplasia. These anomalies may be isolated or associated with other congenital heart diseases. In the current study, MDCT could diagnose all cases of pulmonary arterial anomalies with 96% sensitivity, 100% specificity, 98% accuracy, 100% positive, and 94% negative predictive values. CT scans provide accurate information to assess complex spatial relationships of vascular airway compression frequently associated with CHD in the pediatric population.
Conclusion
MDCT scanner can be an alternative to diagnostic conventional angiography for the non-invasive assessment of the pulmonary artery. Higher quality multiplanar and 3D reconstruction achieved by the MDCT scanners offer a rapid, reliable and non-invasive technique that can be used for the evaluation and preoperative assessment of thoracic vascular and extra-vascular anatomy in infants and children with suspected congenital heart disease. CT technologies are constantly developing collaboration between radiologists, pediatric cardiologists, and anesthesiologists, which is essential for improving CT performance.
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14
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Slioui B, Zaimi A, Chat L. [The contribution of multicut scanner use in arches and of the aortic arch anomalies in children]. Pan Afr Med J 2019; 33:312. [PMID: 31692927 PMCID: PMC6815495 DOI: 10.11604/pamj.2019.33.312.17831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/07/2019] [Indexed: 12/12/2022] Open
Abstract
Congenital malformations of the aortic arches are a heterogeneous group of diseases associated with developmental disorders of the primitive branchial arches during fetal life. The coarctation of the aorta is a common congenital vascular malformation which is a congenital narrowing of the aortic isthmus, a segment of the aorta between the left subclavian artery and the ductus arteriosus. The interruption of the aortic arch is considered by some authors as an extreme coarctation of the aorta, characterized by discontinuity between ascending and descending aorta. These abnormalities are integrated, in most cases, in the context of cardiac malformations from which they are indivisible. CT angiogram plays an essential role in the examination of these abnormalities, their preoperative assessment and their follow-up in the long term. We conducted a retrospective study of 42 patients undergoing CT angiogram following the detection of heart disease on echocardiography. CT angiogram was performed in 6 cases. The average age of patients was 2 years, ranging from 6 days to 14 years; a male predominance was reported with a sex ratio of 1,6. The main diseases were: coarctation of the aorta: 18 cases; hypoplasies of the aortic arch: 8 cases; interruptions of the aortic arch: 7 cases; abnormalities of the aortic arches: 9 cases. Some of these abnormalities were associated. Extracardiac abnormalities associated with congenital heart diseases are relatively frequent; multislice scanner allows for good analysis of the cardiac afferent and efferent pathways. CT complements echocardiogram for pre-treatment assessment of the main malformative diseases, especially for the detection of the associated extra-cardiac vascular abnormalities, thanks to its satisfactory tridimensional multiplanar exploration. It tends to supplant angiography in many pathological malformations for several reasons: it is less invasive; it provides high-resolution 3D images useful to surgeons; it established the anatomical diagnosis, assesses tracheal compression and any associated malformation; it guides surgical treatment.
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Affiliation(s)
- Badr Slioui
- Service d'Imagerie Médicale 4ème Hôpital Militaire Dakhla, Maroc
| | - Achraf Zaimi
- Service de Cardiologie 4ème Hôpital Militaire Dakhla, Maroc
| | - Latifa Chat
- Service d'Imagerie Médicale, Hôpital Pédiatrique Rabat, Maroc
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Muscogiuri G, Suranyi P, Eid M, Varga-Szemes A, Griffith L, Pontone G, Schoepf UJ, De Cecco CN. Pediatric Cardiac MR Imaging:: Practical Preoperative Assessment. Magn Reson Imaging Clin N Am 2019; 27:243-262. [PMID: 30910096 DOI: 10.1016/j.mric.2019.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prevalence of patients with congenital heart disease (CHD) is rapidly increasing due to continuous advancements in diagnostic techniques and medical or surgical treatment approaches. Along with cardiac computed tomography angiography, cardiac magnetic resonance (CMR) serves as a fundamental imaging modality for pre-surgical planning in patients with CHD, as CMR allows for the evaluation of cardiac and great vessel anatomy, biventricular function, flow dynamics, and tissue characterization. This information is essential for risk-assessment and optimal timing of surgical interventions. This article discusses the current role of pediatric cardiac MR imaging as a practical preoperative assessment tool in the pediatric population.
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Affiliation(s)
- Giuseppe Muscogiuri
- Centro Cardiologico Monzino, IRCCS, Via Centro Cardiologico Monzino, Via Carlo Parea, 4, 20138 Milano MI, Italy; Department of Clinical and Molecular Medicine, University of Rome "Sapienza", Rome, Italy
| | - Pal Suranyi
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Marwen Eid
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Akos Varga-Szemes
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Lewis Griffith
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Via Centro Cardiologico Monzino, Via Carlo Parea, 4, 20138 Milano MI, Italy
| | - Uwe Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 5 Courtenay Dr, MUSC, Charleston, SC 29401, USA
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc., 1364 Clifton Road Northeast, Atlanta, GA 30322, USA.
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Hamisa M, Elsharawy F, Elsherbeny W, Bayoumy S. Comparative study between multi-detector computed tomography and echocardiography in evaluation of congenital vascular rings. ALEXANDRIA JOURNAL OF MEDICINE 2018. [DOI: 10.1016/j.ajme.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Manal Hamisa
- Radiodiagnosis Departments, Faculty of Medicine, Tanta University, Egypt
| | - Fatma Elsharawy
- Radiodiagnosis Departments, Faculty of Medicine, Tanta University, Egypt
| | - Wafaa Elsherbeny
- Cardiology Departments, Faculty of Medicine, Tanta University, Egypt
| | - Suzan Bayoumy
- Cardiology Departments, Faculty of Medicine, Tanta University, Egypt
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Oyama-Manabe N, Yabusaki S, Manabe O, Kato F, Kanno-Okada H, Kudo K. IgG4-related Cardiovascular Disease from the Aorta to the Coronary Arteries: Multidetector CT and PET/CT. Radiographics 2018; 38:1934-1948. [DOI: 10.1148/rg.2018180049] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Noriko Oyama-Manabe
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
| | - Satoshi Yabusaki
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
| | - Osamu Manabe
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
| | - Fumi Kato
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
| | - Hiromi Kanno-Okada
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
| | - Kohsuke Kudo
- From the Department of Diagnostic and Interventional Radiology (N.O.M., S.Y., F.K., K.K.) and Department of Surgical Pathology (H.K.O.), Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, Japan 060-8638; and Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan (O.M.)
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Hirsig LE, Sharma PG, Verma N, Rajderkar DA. Congenital Pulmonary Artery Anomalies: A Review and Approach to Classification. J Clin Imaging Sci 2018; 8:29. [PMID: 30147993 PMCID: PMC6085843 DOI: 10.4103/jcis.jcis_9_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/02/2018] [Indexed: 12/04/2022] Open
Abstract
Congenital pulmonary artery anomalies are infrequent but given improved prenatal diagnosis and care, and neonatal surgical advances, over the past two decades are not uncommonly encountered by cardiothoracic imagers. An understanding of their etiology, classifications, associated anomalies, and surgical management can be helpful to avoid under or overdiagnosis. Timely diagnosis assisted by familiarity with imaging findings across modalities and recognition of surgical findings allows for medical management and surgical planning for these patients, with more patients reaching adulthood than ever before.
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Affiliation(s)
- Leslie E Hirsig
- Department of Radiology, Division of Pediatric Imaging, University of Florida College of Medicine, Gainesville, FL 32608, USA
| | - Priya G Sharma
- Department of Radiology, Division of Pediatric Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nupur Verma
- Department of Radiology, Division of Cardiac Imaging, University of Florida College of Medicine, Gainesville, FL 32608, USA
| | - Dhanashree A Rajderkar
- Department of Radiology, Division of Pediatric Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
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19
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Judicael AN, Vouche M, Denaeghel D, Murgo S, Ferreira J. Endovascular management of a rare complication of an aortic coarctation. Radiol Case Rep 2018; 13:614-617. [PMID: 30042807 PMCID: PMC6054709 DOI: 10.1016/j.radcr.2018.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/22/2018] [Indexed: 10/31/2022] Open
Abstract
A 28-year-old pregnant woman presents with arterial hypertension of the upper limbs. The examination suggests an aortic coarctation. After a normal delivery, a contrast-enhanced computed tomography revealed a subocclusive aortic coarctation of the descending thoracic aorta and a 33-mm aneurysm developed from the left cervical-thoracic artery. The coarctation of the aorta was treated by a stent graft, and the aneurysm was treated by an injection of thrombin and glue.
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Affiliation(s)
| | - Michael Vouche
- Department of Angiography, Erasme Hospital, Route de lennik 808, 1070 Bruxelles, Belgium
| | - David Denaeghel
- Department of Angiography, Erasme Hospital, Route de lennik 808, 1070 Bruxelles, Belgium
| | - Salvatore Murgo
- Department of Angiography, Erasme Hospital, Route de lennik 808, 1070 Bruxelles, Belgium
| | - José Ferreira
- Department of Cardio-Vascular Surgery, Erasme Hospital, Bruxelles, Belgium
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20
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Interrupted aortic arch diagnosis by computed tomography angiography and 3-D reconstruction: A case report. Radiol Case Rep 2018; 13:35-38. [PMID: 29552241 PMCID: PMC5851190 DOI: 10.1016/j.radcr.2017.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/27/2017] [Accepted: 10/01/2017] [Indexed: 11/22/2022] Open
Abstract
Interrupted aortic arch is an extremely rare congenital malformation representing about 1% of congenital heart disease. Early symptoms usually occur early in the neonatal period and clinical deterioration is often rapid and long-term prognosis is limited. Nonetheless, this condition has been identified later in adult life in rare cases. We report a case in an adult male with absence of hypertension history and no further cardiac compromise, with a severe posterior chest pain alongside dyspnea and sweating. Computed tomography angiography revealed interrupted aortic arch type A, bivalve aorta, hemopericardium, aortic dissection Stanford A, and important collateral circulation.
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21
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Avendaño-Pérez L, Soto ME, Ávila-Vanzzini N, Bracamontes-Castelo G, Ruán-Díaz JC, Alexanderson-Rosas E, Espinola-Zavaleta N. Mechanical deformation in adult patients with unrepaired aortic coarctation. Int J Cardiovasc Imaging 2017; 34:735-741. [PMID: 29189934 DOI: 10.1007/s10554-017-1286-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/28/2017] [Indexed: 01/16/2023]
Abstract
Aortic coarctation is a congenital heart disease that causes an increased left ventricular afterload, resulting in increased systolic parietal tension, compensatory hypertrophy, and left ventricular systolic and diastolic dysfunction. The speckle tracking is a new echocardiographic technique that allows the detection of subclinic left ventricular systolic dysfunction. The aim of this study was to detect early left ventricular dysfunction using mechanical deformation by echocardiography in adults with un-repaired aortic coarctation. A total of 41 subjects were studied, 20 patients with aortic coarctation and 21 control subjects, 21 women (51.2%), with an average age of 30 ± 10 years. All patients with aortic coarctation had systemic arterial hypertension (p < 0.001). Seventy percent (14/20) of the patients had bicuspid aortic valve. Statistically significance (p < 0.005) were found in left ventricular mass index, E/e ratio, pulmonary artery systolic pressure and peak velocity and maximum gradient of the aortic valve. The global longitudinal deformation of the left ventricle in patients with aortic coarctation was significative decreased, p < 0.001. The ejection fraction and the global longitudinal deformation of the left ventricle were significantly lower in patients with aortic coarctation compared to the control group, p < 0.003, p < 0.001, respectively. The subgroup of patients with coarctation and left ventricular ejection fraction < 55% had a marked decrease in global longitudinal strain (- 15.9 ± 4%). The radial deformation was increased in patients with aortic coarctation and showed a trend to be significant (r = 0.421; p < 0.06). A significant negative correlation was observed between the global longitudinal deformation and left ventricular mass index (r = 0.54; p = 0.01) in the aortic coarctation group. The patients with aortic coarctation and left ventricular hypertrophy had marked reduction of left ventricular global longitudinal deformation (- 16%, p < 0.05). In our study patients with normal left ventricular ejection fraction had abnormal global longitudinal deformation and also the increased left ventricular mass was related with a decreased left ventricular global longitudinal deformation as a sign of subclinical systolic dysfunction.
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Affiliation(s)
- Leonel Avendaño-Pérez
- Laboratory of Echocardiography and Non-invasive Hemodynamics, National Institute of Cardiology "Ignacio Chávez", Juan Badiano No 1, Colonia Sección XVI, Tlalpan, C. P. 14030, Mexico City, Mexico
| | - María Elena Soto
- Department Immunology, National Institute of Cardiology "Ignacio Chavez", Mexico City, Mexico
| | - Nydia Ávila-Vanzzini
- Department of Out-patients Clinic, National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico
| | - Guillermo Bracamontes-Castelo
- Laboratory of Echocardiography and Non-invasive Hemodynamics, National Institute of Cardiology "Ignacio Chávez", Juan Badiano No 1, Colonia Sección XVI, Tlalpan, C. P. 14030, Mexico City, Mexico
| | - José Carlos Ruán-Díaz
- Laboratory of Echocardiography and Non-invasive Hemodynamics, National Institute of Cardiology "Ignacio Chávez", Juan Badiano No 1, Colonia Sección XVI, Tlalpan, C. P. 14030, Mexico City, Mexico
| | - Erick Alexanderson-Rosas
- Department of Nuclear Medicine, National Institute of Cardiology "Ignacio Chavez", Mexico City, Mexico
| | - Nilda Espinola-Zavaleta
- Laboratory of Echocardiography and Non-invasive Hemodynamics, National Institute of Cardiology "Ignacio Chávez", Juan Badiano No 1, Colonia Sección XVI, Tlalpan, C. P. 14030, Mexico City, Mexico.
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22
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Tamayo-Espinosa T, Erdmenger-Orellana J, Becerra-Becerra R, Balderrabano-Saucedo N, Segura-Standford B. Arco aórtico derecho con subclavia izquierda aberrante y divertículo de Kommerell. Una causa de anillo vascular. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2017. [DOI: 10.1016/j.acmx.2017.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Guner A, Havan N, Gunduz S, Akgun T, Guvendi B, Kahveci G. Evaluation of the congenital supravalvular aortic stenosis by different imaging modalities. Echocardiography 2017; 34:1376-1378. [PMID: 28681443 DOI: 10.1111/echo.13627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A 36-year-old female was admitted to hospital exhibiting chest pain, dyspnea, and a heart murmur on the right upper sternal border, radiating to both carotid arteries. The blood pressure of the patient's right arm exceeded the pressure in the left by 25 mm Hg (Coanda effect). In spite of laboratory results that did not fall outside the expected range, the left ventricle was revealed to be hypertrophic following electrocardiography. Transthoracic echocardiography revealed a severe supravalvular aortic stenosis (SVAS) with a peak Doppler velocity of 6.04 cm/s and an estimated mean pressure gradient of 89 mm Hg, with moderate aortic and mitral regurgitation. Contrast-enhanced computed tomography (CCT) indicated a partial hourglass-shaped narrowing of the ascending aorta. Lesions associated with supravalvular stenosis of the pulmonary artery, patent ductus arteriosus, and aortic coarctation were ruled out by the CCT. Congenital SVAS is a rare heart condition, and three anatomically distinct forms have been described. The most common type is the "hourglass," which produces a marked thickening and disorganization of the aortic tissue, producing a constricting annular ridge at the superior margin of the sinuses of Valsalva.
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Affiliation(s)
- Ahmet Guner
- Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
| | - Nuri Havan
- Department of Radiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
| | - Sabahattin Gunduz
- Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
| | - Taylan Akgun
- Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
| | - Busra Guvendi
- Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
| | - Gokhan Kahveci
- Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, Istanbul, Turkey
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Shehata S, Zaiton F, Abo Warda M, Shahbah D, Ebrahim B. Value of MDCT as a non- invasive modality in evaluation of pediatric congenital cardiovascular anomalies. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sequential segmental classification of feline congenital heart disease. J Vet Cardiol 2016; 17 Suppl 1:S10-52. [PMID: 26776571 DOI: 10.1016/j.jvc.2015.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 04/01/2015] [Accepted: 04/21/2015] [Indexed: 12/17/2022]
Abstract
Feline congenital heart disease is less commonly encountered in veterinary medicine than acquired feline heart diseases such as cardiomyopathy. Understanding the wide spectrum of congenital cardiovascular disease demands a familiarity with a variety of lesions, occurring both in isolation and in combination, along with an appreciation of complex nomenclature and variable classification schemes. This review begins with an overview of congenital heart disease in the cat, including proposed etiologies and prevalence, examination approaches, and principles of therapy. Specific congenital defects are presented and organized by a sequential segmental classification with respect to their morphologic lesions. Highlights of diagnosis, treatment options, and prognosis are offered. It is hoped that this review will provide a framework for approaching congenital heart disease in the cat, and more broadly in other animal species based on the sequential segmental approach, which represents an adaptation of the common methodology used in children and adults with congenital heart disease.
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28
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Silva AF, Dos Santos JA. Aortic arch anomaly in an adult patient: a case of right aortic arch with aberrant left subclavian artery and Kommerell's diverticulum. Radiol Bras 2016; 49:274-275. [PMID: 27777488 PMCID: PMC5073401 DOI: 10.1590/0100-3984.2015.0087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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29
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Gach P, Dabadie A, Sorensen C, Quarello E, Bonello B, Pico H, Hugues N, Petit P, Gorincour G. Multimodality imaging of aortic coarctation: From the fetus to the adolescent. Diagn Interv Imaging 2016; 97:581-90. [PMID: 27132712 DOI: 10.1016/j.diii.2016.03.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 03/06/2016] [Accepted: 03/10/2016] [Indexed: 10/21/2022]
Abstract
Aortic coarctation is a local narrowing of the aortic lumen, which is located at the level of the isthmus in 95% of patients. Aortic coarctation accounts for 5 to 8% of all congenital heart diseases. It may have an acute presentation in the form of heart failure in the neonate or may be discovered incidentally in adult because of severe treatment-resistant hypertension. Ultrasound may reveal the presence of aortic coarctation during the antenatal period. In this situation, associated abnormalities should be investigated (including karyotype), because they influence prognosis and indicates whether or not the birth should occur in a center with pediatric cardiology expertise. Postnatally, ultrasound and chest radiography are the basic imaging work-up. Computed tomography is often the second line imaging investigation in infants and young children for whom magnetic resonance imaging fails to confirm the diagnosis. Magnetic resonance imaging with cardiac synchronization is the preferred imaging tool in the post-treatment period. Aortic coarctation may be treated surgically or by endovascular techniques. Potential complications should be searched for using ultrasound and magnetic resonance imaging.
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Affiliation(s)
- P Gach
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France.
| | - A Dabadie
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - C Sorensen
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - E Quarello
- Institut méditerranéen de la reproduction et fondation, hôpital Saint-Joseph, 13008 Marseille, France
| | - B Bonello
- Département de cardiopédiatrie médicochirurgicale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - H Pico
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - N Hugues
- Département de cardiopédiatrie médicochirurgicale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - P Petit
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France
| | - G Gorincour
- Service d'imagerie pédiatrique et prénatale, hôpital de la Timone-Enfants, 13005 Marseille, France
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Sousa I, Campos P, Távora I. Coartação e pseudocoartação da aorta no adulto – diferenças e semelhanças em tomografia computorizada. ANGIOLOGIA E CIRURGIA VASCULAR 2016. [DOI: 10.1016/j.ancv.2016.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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31
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Jugpal TS, Garg A, Sethi GR, Daga MK, Kumar J. Multi-detector computed tomography imaging of large airway pathology: A pictorial review. World J Radiol 2015; 7:459-474. [PMID: 26753061 PMCID: PMC4697120 DOI: 10.4329/wjr.v7.i12.459] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
The tracheobronchial tree is a musculo-cartilagenous framework which acts as a conduit to aerate the lungs and consequently the entire body. A large spectrum of pathological conditions can involve the trachea and bronchial airways. These may be congenital anomalies, infections, post-intubation airway injuries, foreign body aspiration or neoplasms involving the airway. Appropriate management of airway disease requires an early and accurate diagnosis. In this pictorial essay review, we will comprehensively describe the various airway pathologies and their imaging findings by multi-detector computed tomography.
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Useful signs for the assessment of vascular rings on cross-sectional imaging. Pediatr Radiol 2015; 45:2004-16; quiz 2002-3. [PMID: 26260202 DOI: 10.1007/s00247-015-3424-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 05/16/2015] [Accepted: 06/19/2015] [Indexed: 01/24/2023]
Abstract
Vascular rings can be challenging to diagnose because they can contain atretic portions not detectable with current imaging modalities. In these cases, where the compressed airway and esophagus are not encircled by patent, opacified vessels, there are useful secondary signs that should be considered and should raise suspicion for the presence of a vascular ring. These signs include a double aortic arch, the four-vessel sign, the distorted subclavian artery sign, a diverticulum of Kommerell, a ductal diverticulum contralateral to the aortic arch, and a descending aorta contralateral to the arch or circumflex aorta. If none of these findings is present, a ring can be excluded with confidence.
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33
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Nance JW, Ringel RE, Fishman EK. Coarctation of the aorta in adolescents and adults: A review of clinical features and CT imaging. J Cardiovasc Comput Tomogr 2015; 10:1-12. [PMID: 26639936 DOI: 10.1016/j.jcct.2015.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/12/2015] [Accepted: 11/10/2015] [Indexed: 01/06/2023]
Abstract
Coarctation of the aorta (CoA), while usually identified and treated in the neonatal/infant period, is increasingly seen in adults, either primarily or (more often) following repair. Imaging plays a crucial role in the diagnosis, therapeutic planning, and follow-up of patients with CoA. Clinical management of CoA in adults optimally involves a multidisciplinary team; accordingly, imagers should be familiar with the underlying pathology, associations, and management of CoA in addition to imaging protocoling and interpretation. We will review the relevant clinical and imaging features of CoA, with an emphasis on patients beyond childhood.
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Affiliation(s)
- John W Nance
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, 601 N. Caroline St, Baltimore, MD, USA
| | - Richard E Ringel
- Department of Pediatrics, Johns Hopkins School of Medicine, 601 N. Caroline St, Baltimore, MD, USA
| | - Elliot K Fishman
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, 601 N. Caroline St, Baltimore, MD, USA.
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Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT). J Cardiovasc Comput Tomogr 2015; 9:475-92. [DOI: 10.1016/j.jcct.2015.07.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
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Yoshida R, Katsube T, Yoshizako T, Kitagaki H. Focal pulmonary interstitial opacities adjacent to the thoracic spine osteophytes among the cases with right-sided aortic arch. SPRINGERPLUS 2015; 4:415. [PMID: 26295014 PMCID: PMC4532694 DOI: 10.1186/s40064-015-1212-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/03/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the factors to development of focal pulmonary interstitial opacities adjacent to thoracic spine osteophytes among cases with right-sided aortic arch. MATERIALS AND METHODS This was a retrospective review of our hospital information system on patients with right-sided aortic arch who underwent chest computed tomography (CT) from April 2003 to September 2014. CT were reviewed to evaluate the position and thickness of osteophytes and that of focal pulmonary opacities adjacent to osteophytes, comparing data between the patients with osteophytes with pulmonary opacity (group A) and patients with osteophytes without pulmonary opacity (group B). RESULTS There were 25 patients totally, 23 cases of left-sided thoracic osteophytes, two cases on both sides. Comparing Group A (n = 10) and Group B (n = 15), the presence of pulmonary opacities was significantly associated with thickness of osteophytes (Mann-Whitney U test, P < 0.05). CONCLUSION In patients with right-sided aortic arch, thoracic osteophytes were often observed on the left side. The presence of pulmonary opacities adjacent to thoracic osteophytes was associated with thickness of osteophytes. Furthermore, these interstitial opacities should not be considered a preclinical form of fibrosing lung disease.
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Affiliation(s)
- Rika Yoshida
- Department of Radiology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Takashi Katsube
- Department of Radiology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Takeshi Yoshizako
- Department of Radiology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane 693-8501 Japan
| | - Hajime Kitagaki
- Department of Radiology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane 693-8501 Japan
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Abstract
OBJECTIVE. The purpose of this article is to summarize the roles of CT and MRI in the diagnosis and follow-up of patients with aortic coarctation. CONCLUSION. Aortic coarctation is a common congenital heart disease accounting for approximately 6-8% of congenital heart defects. Despite its deceptively simple anatomic presentation, it is a complex medical problem with several associated anatomic and physiologic abnormalities. CT and MRI may provide very accurate information of the coarctation anatomy and other associated cardiac abnormalities.
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Cardiac CT angiography beyond the coronary arteries: what radiologists need to know and why they need to know it. AJR Am J Roentgenol 2015; 203:W583-95. [PMID: 25415723 DOI: 10.2214/ajr.13.12400] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE With current state-of-the-art CT combining fast scanning times and high spatial resolution, anatomy beyond the coronary arteries is well visualized and may lead to discovery of abnormalities. The purpose of this article is to provide a strategy for radiologists to recognize important extracoronary cardiac CT angiography (CTA) findings. CONCLUSION A systemic approach to cardiac CTA by anatomic location and attention to key CT features are critical to identify and properly characterize important extracoronary cardiac abnormalities.
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Nie P, Yang G, Wang X, Duan Y, Xu W, Li H, Cao T, Liu X, Ji X, Cheng Z, Wang A. Application of prospective ECG-gated high-pitch 128-slice dual-source CT angiography in the diagnosis of congenital extracardiac vascular anomalies in infants and children. PLoS One 2014; 9:e115793. [PMID: 25546178 PMCID: PMC4278836 DOI: 10.1371/journal.pone.0115793] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/26/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To investigate the value of prospective ECG-gated high-pitch 128-slice dual-source CT (DSCT) angiography in the diagnosis of congenital extracardiac vascular anomalies in infants and children in comparison with transthoracic echocardiography (TTE). METHODS Eighty consecutive infants or children clinically diagnosed of congenital heart disease and suspected with extracardiac vascular anomaly were enrolled, and 75 patients were finally included in this prospective study. All patients underwent prospective ECG-gated high-pitch DSCT angiography after TTE with an interval of 1-7 days. The diagnostic accuracy and sensitivity of high-pitch DSCT angiography and TTE were compared according to the surgical/CCA findings. The image quality of DSCT was assessed using a five-point scale. The effective radiation dose (ED) was calculated. RESULTS A total of 17 congenital heart diseases and 162 separate extracardiac vascular anomalies were confirmed by surgical/CCA findings in 75 patients. The diagnostic accuracy of high-pitch DSCT angiography and TTE was 99.67% and 97.89%, respectively. The sensitivity of high-pitch DSCT angiography and TTE was 97.53% and 79.62%, respectively. There was significant difference regarding to the diagnostic accuracy and the sensitivity between high-pitch DSCT angiography and TTE (χ2 = 23.561 and 28.013, P<0.05). The agreement on the image quality scoring of DSCT between the two observers was excellent (κ = 0.81), and the mean score of image quality was 4.1±0.7. The mean ED of DSCT was 0.29±0.08 mSv. CONCLUSIONS Prospective ECG-gated high-pitch 128-slice DSCT angiography with low radiation dose and high diagnostic accuracy has higher sensitivity compared to TTE in the detection of congenital extracardiac vascular anomalies in infants and children.
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Affiliation(s)
- Pei Nie
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Guangjie Yang
- Department of Nuclear Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Ximing Wang
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
- * E-mail:
| | - Yanhua Duan
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
| | - Wenjian Xu
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Haiou Li
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
| | - Ting Cao
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
| | - Xuejun Liu
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaopeng Ji
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
| | - Zhaoping Cheng
- Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Jinan, Shandong, China
| | - Anbiao Wang
- Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong, China
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Smith BM, Lu JC, Dorfman AL, Mahani MG, Agarwal PP. Rings and slings revisited. Magn Reson Imaging Clin N Am 2014; 23:127-35. [PMID: 25476681 DOI: 10.1016/j.mric.2014.09.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vascular rings and pulmonary artery slings are rare congenital anomalies that often present with symptoms of tracheal and esophageal compression. These can involve the aortic arch branches and pulmonary arteries, respectively. This review illustrates the current role of MR imaging, highlights its advantages, and provides insight into the diagnosis of these anomalies by describing the embryology and characteristic imaging features of these lesions.
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Affiliation(s)
- Brandon M Smith
- Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA.
| | - Jimmy C Lu
- Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA; Division of Pediatric Radiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Adam L Dorfman
- Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA; Division of Pediatric Radiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Maryam Ghadimi Mahani
- Division of Pediatric Radiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Prachi P Agarwal
- Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Lempel JK, Frazier AA, Jeudy J, Kligerman SJ, Schultz R, Ninalowo HA, Gozansky EK, Griffith B, White CS. Aortic Arch Dissection: A Controversy of Classification. Radiology 2014; 271:848-55. [DOI: 10.1148/radiol.14131457] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Santos Armentia E, Tardáguila De La Fuente G, Castellón Plaza D, Delgado Sánchez-Gracián C, Prada González R, Fernández Fernández L, Tardáguila Montero F. Dual energy CT angiography of the carotid arteries: Quality, bone subtraction, and radiation dosage using tube voltage 80/140kV versus 100/140kV. RADIOLOGIA 2014. [DOI: 10.1016/j.rxeng.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Role of 16-multidetector CT angiography in assessment of arterial and venous pulmonary anomalies in pediatrics. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2013. [DOI: 10.1016/j.ejrnm.2013.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Diagnosis of congenital aortic arch anomalies in chinese children by multi-detector computed tomography angiography. ACTA ACUST UNITED AC 2013; 33:447-451. [DOI: 10.1007/s11596-013-1140-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Indexed: 11/25/2022]
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Saade C, Bourne R, Wilkinson M, Brennan PC. MDCT angiography of the major congenital anomalies of the extracranial arteries: pictorial review. J Med Imaging Radiat Oncol 2013; 57:321-8. [PMID: 23721141 DOI: 10.1111/j.1754-9485.2012.02447.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 05/22/2012] [Indexed: 11/30/2022]
Abstract
Multidetector computed tomographic angiography is becoming the modality of choice for evaluation of the supra-aortic circulation in acute stroke imaging. Variations of the supra-aortic circulation, in particular of the extracranial arteries, are common. This article aims to provide a pictorial description of the variant anatomy of the aortic arch and extracranial arteries. Knowledge of the presence and clinical relevance of normal variants such as anomalies, duplications and embryological persistence plays a clinically relevant role in the diagnosis and management of neurological and surgical conditions, particularly as we enter an era of increasing extracranial intervention.
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Affiliation(s)
- Charbel Saade
- Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia.
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Szpinda M, Szpinda A, Woźniak A, Mila-Kierzenkowska C, Kosiński A, Grzybiak M. Quantitative anatomy of the growing abdominal aorta in human fetuses: an anatomical, digital and statistical study. Med Sci Monit 2013; 18:BR419-26. [PMID: 23018350 PMCID: PMC3560560 DOI: 10.12659/msm.883483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Advances in perinatal medicine have required an extensive knowledge of fetal aorto-iliac measurements. The present study was performed to compile reference data for dimensions of the abdominal aorta at varying gestational ages. Material/Methods Using the methods of anatomical dissection, digital-image analysis (Leica QWin Pro 16 system), and statistical analysis (Student’s t-test, one-way ANOVA, post-hoc RIR Tukey test, regression analysis, and Wilcoxon signed-rank test), the growth of length (mm), proximal and distal external diameters (mm), and volume (mm3) of the abdominal aorta in 124 (60 male, 64 female) spontaneously aborted human fetuses aged 15–34 weeks was examined. Results No significant male-female differences were found. The length ranged from 9.35±1.24 to 36.29±4.98 mm, according to the linear function y=−14.596+1.519 × Age ±2.639 (R2=0.92; p<0.0001). The proximal external diameter varied from 1.18±0.25 to 5.19±0.49 mm, according to the linear pattern y=−2.065+0.212 × Age ±0.348 (R2=0.92; p<0.0001). The distal external diameter increased from 1.03±0.23 to 4.92±0.46 mm, in accordance with the linear model y=−2.097+0.203 × Age ±0.351 (R2=0.92; p<0.0001). Both length and proximal external diameter of the abdominal aorta indicated a proportionate evolution, because the length-to-proximal external diameter ratio was stable, following the linear function y=7.724–0.017 × Age ±0.925. The abdominal aorta volume ranged from 9.6±4.5 to 740.5±201.8 mm3, given by the quadratic function y=911–101 × Age +2.838 × Age2 ±78 (R2=0.89; p<0.0001). Conclusions There are no significant differences between males and females for morphometric parameters of the abdominal aorta. The abdominal aorta grows linearly in both length and diameters, and parabolically in volume. These detailed morphometric data of the abdominal aorta provide a database for intra-uterine echographic examinations in the early diagnosis, monitoring and management of aorto-iliac malformations.
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Affiliation(s)
- Michał Szpinda
- Department of Normal Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.
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Szpinda M, Szpinda A, Flisiński P, Flisiński P. The normal growth of cross-sectional areas of the aorto-iliac segment in human fetuses - an anatomical, digital, and statistical study. Med Sci Monit Basic Res 2013; 19:46-53. [PMID: 23370918 PMCID: PMC3638685 DOI: 10.12659/msmbr.883756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The intraluminal size of the aorto-iliac segment is relevant in both the clinical and echographic settings. The aim of this study was to compile both the absolute and relative age-specific reference intervals for cross-sectional areas (CSAs) of the aorto-iliac segment. MATERIAL/METHODS Using the methods of anatomical dissection, digital-image analysis (Leica QWin Pro 16) and statistical analysis (Student's t test, one-way ANOVA, post-hoc RIR Tukey test, linear regression), the growth in CSA (in mm2) of the abdominal aorta, the common, external, and internal iliac arteries in 124 (60 males, 64 females) spontaneously aborted human fetuses aged 15-34 weeks was examined. RESULTS No significant sex differences were found. In the age range of 4-9 months, the distal CSA of the abdominal aorta ranged from 0.87±0.34 to 19.18±3.36 mm2. The CSA of the common iliac artery varied from 0.37±0.22 to 4.30±1.54 mm2 on the right, and from 0.36±0.16 to 3.80±1.44 mm2 on the left. The sum of the CSAs of the right and left common iliac arteries grew proportionately to the distal CSA of the abdominal aorta; the latter being significantly larger than the former. On both sides, however, the CSA of the internal iliac artery was approximately twice that of the external iliac artery. Between the ages of 4 and 9 months, the CSA of the external iliac artery ranged from 0.10±0.06 to 1.32±0.52 mm2 on the right, and from 0.08±0.03 to 1.19±0.42 mm2 on the left. The CSA of the internal iliac artery increased from 0.23±0.14 to 2.59±1.22 mm2 on the right, and from 0.21±0.14 to 2.27±1.11 mm2 on the left. Bilaterally, the sum of the CSAs of the internal and external iliac arteries was significantly smaller than the CSA of the common iliac artery. The relative CSA of each artery decreased until the age of 6 months, after which their values were gradually increasing until the age of 9 months. CONCLUSIONS The aorto-iliac segment does not reveal sex differences in its cross-sectional area. The cross-sectional area of the internal iliac artery is approximately twice the size of the external iliac artery. The aorto-iliac segment observed proximally to distally reduces its cross-sectional area, thereby resulting in an increase in blood velocity.
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Affiliation(s)
- Michał Szpinda
- Department of Normal Anatomy, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.
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The value of low-dose prospective ECG-gated dual-source CT angiography in the diagnosis of coarctation of the aorta in infants and children. Clin Radiol 2012; 67:738-45. [DOI: 10.1016/j.crad.2011.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/10/2011] [Accepted: 12/19/2011] [Indexed: 11/20/2022]
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Murillo H, Lane MJ, Punn R, Fleischmann D, Restrepo CS. Imaging of the Aorta: Embryology and Anatomy. Semin Ultrasound CT MR 2012; 33:169-90. [DOI: 10.1053/j.sult.2012.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Restrepo CS, Melendez-Ramirez G, Kimura-Hayama E. Multidetector Computed Tomography of Congenital Anomalies of the Thoracic Aorta. Semin Ultrasound CT MR 2012; 33:191-206. [DOI: 10.1053/j.sult.2011.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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