1
|
Prountzos S, Papakonstantinou O, Bizimi V, Velonakis G, Mazioti A, Douros K, Alexopoulou E. Large airway diseases in pediatrics: a pictorial essay. Acta Radiol Open 2021; 9:2058460120972694. [PMID: 33403124 PMCID: PMC7747119 DOI: 10.1177/2058460120972694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
“Large airway diseases” is being used as an all-encompassing phrase to describe a broad spectrum of pathological entities, which involves the trachea, main, lobar, and segmental bronchi of up to 3 mm diameter. Imaging modalities such as radiography, computed tomography, and magnetic resonance imaging contribute to the identification and diagnosis of each entity. Knowledge of clinical information, normal cross-sectional anatomy, and imaging characteristics of large airway diseases is necessary for appropriate radiologic evaluation. This review provides information about congenital and acquired diseases of the large airways in the pediatric population.
Collapse
Affiliation(s)
- Spyridon Prountzos
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| | - Olympia Papakonstantinou
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| | - Vasiliki Bizimi
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| | - Georgios Velonakis
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| | - Argyro Mazioti
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| | - Konstantinos Douros
- Allergology and Pulmonology Unit, 3rd Pediatric Department, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymia Alexopoulou
- 2nd Department of Radiology, National and Kapodistrian University of Athens, "Attikon" University Hospital of Athens, Athens, Greece
| |
Collapse
|
2
|
Guo Q, Kong Y, Zeng S, Zhou J, Wang X, Shang Q, Zhou J, Yuan H, Wang L, Tong L, Yi A, Zhou Q. Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes. BMC Pregnancy Childbirth 2020; 20:614. [PMID: 33046002 PMCID: PMC7552480 DOI: 10.1186/s12884-020-03300-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022] Open
Abstract
Background Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. Methods The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated. Results A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA. Conclusions Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.
Collapse
Affiliation(s)
- Qiao Guo
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China.,Department of Obstetrics, Xiangya Hospital of Central South University, 87 Xiangya Road, 410008, Changsha, Hunan, China
| | - Yifan Kong
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China
| | - Shi Zeng
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China
| | - Jiawei Zhou
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China
| | - Xiaofang Wang
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China
| | - Quanliang Shang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jia Zhou
- Department of Ultrasonography, the First Affiliated Hospital of South China University, Hengyang, Hunan, China
| | - Hongxia Yuan
- Department of Ultrasonography, Changsha Hospital for Maternal and Child Health Care, Changsha, Hunan, China
| | - Ling Wang
- Department of Ultrasonography, Women and Children Healthcare Hospital of Zhuzhou, Zhuzhou, Hunan, China
| | - Lili Tong
- Department of Ultrasonography, Maternal and Child Health Care Hospital of Changde, Changde, Hunan, China
| | - Aijiao Yi
- Department of Ultrasonography, the First People's Hospital of Yueyang, Yueyang, Hunan, China
| | - Qichang Zhou
- Department of Ultrasonography, Second Xiangya Hospital of Central South University, 139 Renmin Road (M), 410011, Changsha, Hunan, China.
| |
Collapse
|
3
|
Ben Saad A, Fahem N, Ben Saad H, Migaou A, Kortas C, Joobeur S. Rare case of vascular ring with Kommerell diverticulum mimicking uncontrolled asthma. Respirol Case Rep 2020; 8:e00535. [PMID: 32076553 PMCID: PMC7029337 DOI: 10.1002/rcr2.535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/19/2020] [Accepted: 01/27/2020] [Indexed: 11/12/2022] Open
Abstract
Anomalies of the aortic arch associated with Kommerell diverticulum (KD) are rare congenital malformations. Symptomatic thoracic vascular rings presenting in adults are rare. We report a case of a 39-year-old woman who was diagnosed with uncontrolled asthma. She was complaining of worsening respiratory symptoms with dysphagia. Imaging studies and preoperative findings concluded to type II congenital anomaly of the aortic arch or Neuhauser's anomaly: a right-sided aortic arch with aberrant left subclavian artery, tracheoesophageal compression by KD and ligamentum arteriosum (LA). This compression was relieved by the resection of the LA and KD.
Collapse
Affiliation(s)
- Ahmed Ben Saad
- Pulmonology DepartmentFattouma Bourguiba Teaching HospitalMonastirTunisia
| | - Nesrine Fahem
- Pulmonology DepartmentFattouma Bourguiba Teaching HospitalMonastirTunisia
| | - Houda Ben Saad
- Medical Department, Cardiology DivisionMoknine HospitalMonastirTunisia
| | - Asma Migaou
- Pulmonology DepartmentFattouma Bourguiba Teaching HospitalMonastirTunisia
| | - Chokri Kortas
- Department of Cardiovascular and Thoracic SurgerySahloul University HospitalSousseTunisia
| | - Samah Joobeur
- Pulmonology DepartmentFattouma Bourguiba Teaching HospitalMonastirTunisia
| |
Collapse
|
4
|
Priya S, Thomas R, Nagpal P, Sharma A, Steigner M. Congenital anomalies of the aortic arch. Cardiovasc Diagn Ther 2018; 8:S26-S44. [PMID: 29850417 DOI: 10.21037/cdt.2017.10.15] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Congenital anomalies of the aortic arch include diverse subgroups of malformations that may be clinically silent or may present with severe respiratory or esophageal symptoms especially when associated with complete vascular rings. These anomalies may be isolated or may be associated with other congenital heart diseases. Volume rendered computed tomography (CT) and magnetic resonance angiography (MRA) help in preoperative surgical planning by providing information about the complex relationship of aortic arch and its branches to the trachea and esophagus. Three dimensional capabilities of both computed tomography angiography (CTA) and MRA are helpful in determining evidence of tracheal or esophageal compression or other high-risk features in patients with a complete vascular ring.
Collapse
Affiliation(s)
- Sarv Priya
- Division of Non-Invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard Thomas
- Division of Non-Invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Prashant Nagpal
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa, USA
| | - Arun Sharma
- Department of Cardiovascular Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Michael Steigner
- Division of Non-Invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|