Comparative study between multi-detector computed tomography and echocardiography in evaluation of congenital vascular rings

Abstract

Vascular rings are unusual anomalies represent less than 1% of all cardiac anomalies, it is abnormal development of aortic arch complex leading to formation of a ring formed by vessels that encircle both the trachea and esophagus, echocardiography had limited acoustic window which leads to inadequate evaluation of great vessels, Multi-detector computed tomography (MDCT) is one of the most important non invasive diagnostic tool for detection the vascular ring anomalies.

The Aim: To evaluate role of MDCT Scanning for diagnosis of congenital vascular rings anomalies compared to echocardiography.

Methods: This is a prospective study of 21 children suspected to have vascular ring anomalies. All patients underwent chest radiography, echocardiography examinations and MDCT Scanning using a 128-row CT scanner with 3D reconstruction.

Results: Twenty-one patients (11 male and 10 female), mean age (14 months) were diagnosed as vascular ring anomalies by MDCT then confirmed by surgical results MDCT diagnosed 14 patients with (double aortic arch), 4 patients (right sided aortic arch with aberrant left subclavian), 2 patients (left sided aortic arch with aberrant right subclavian artery) and one patient with pulmonary sling. MDCT also diagnosed seven patients with tracheobronchial stenosis. Echocardiography succeeded only in nine patients with DAA and failed in five and succeeded in diagnosis of two cases of (right aortic arch with aberrant left subclavian).

Conclusion: MDCT is an excellent diagnostic tool for optimum detection of vascular ring anomalies and other extra cardiac lesions compared to echocardiography.

Keywords: Vascular ring, MDCT, Double aortic arch, Congenital heart disease