Document Detail


MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience.
MedLine Citation:
PMID:  18038169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mediastinal aortic vascular anomalies are relatively common causes of extrinsic central airway narrowing in infants with respiratory symptoms. Surgical correction of mediastinal aortic vascular anomalies alone might not adequately treat airway symptoms if extrinsic narrowing is accompanied by intrinsic tracheomalacia (TM), a condition that escapes detection on routine end-inspiratory imaging. Paired inspiratory-expiratory multidetector CT (MDCT) has the potential to facilitate early diagnosis and timely management of TM in symptomatic infants with mediastinal aortic vascular anomalies. OBJECTIVE: To assess the technical feasibility of paired inspiratory-expiratory MDCT for evaluating TM among symptomatic infants with mediastinal aortic vascular anomalies. MATERIALS AND METHODS: The study group consisted of five consecutive symptomatic infants (four male, one female; mean age 4.1 months, age range 2 weeks to 6 months) with mediastinal aortic vascular anomalies who were referred for paired inspiratory-expiratory MDCT during a 22-month period. CT angiography was concurrently performed during the end-inspiration phase of the study. Two pediatric radiologists in consensus reviewed all CT images in a randomized and blinded fashion. The end-inspiration and end-expiration CT images were reviewed for the presence and severity of tracheal narrowing. TM was defined as > or =50% reduction in tracheal cross-sectional luminal area between end-inspiration and end-expiration. The presence of TM was compared to the bronchoscopy results when available (n = 4). RESULTS: Paired inspiratory-expiratory MDCT was technically successful in all five patients. Mediastinal aortic vascular anomalies included a right aortic arch with an aberrant left subclavian artery (n = 2), innominate artery compression (n = 2), and a left aortic arch with an aberrant right subclavian artery (n = 1). Three (60%) of the five patients demonstrated focal TM at the level of mediastinal aortic vascular anomalies. The CT results were concordant with the results of bronchoscopy in all patients who underwent bronchoscopy (n = 4). CONCLUSION: Paired inspiratory-expiratory MDCT is technically feasible for evaluating TM in symptomatic infants with mediastinal aortic vascular anomalies and has the potential to facilitate prompt diagnosis and treatment.
Authors:
Edward Y Lee; Keira P Mason; David Zurakowski; David A Waltz; Amy Ralph; Farhana Riaz; Phillip M Boiselle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-16
Journal Detail:
Title:  Pediatric radiology     Volume:  38     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-11-26     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  82-8     Citation Subset:  IM    
Affiliation:
Departments of Radiology and Medicine, Pulmonary Division, Children's Hospital Boston and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA. Edward.Lee@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic / abnormalities*,  radiography*
Bronchoscopy
Contrast Media
Feasibility Studies
Female
Humans
Infant
Infant, Newborn
Male
Mediastinum
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Tomography, X-Ray Computed / methods*
Tracheal Diseases / radiography*
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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