BACKGROUND: Congenital upper airway obstruction and dysphagia may be caused by vascular rings and slings. Often, invasive and radiation-dependent diagnostic procedures are needed to clarify the diagnosis. OBJECTIVE: To evaluate the diagnostic utility of high-resolution, free-breathing three-dimensional double-slab fast imaging with steady precession magnetic resonance angiography (3D FISP MRA) in infants and children with respiratory upper airway obstruction and/or dysphagia for detection or exclusion of vascular rings and slings. MATERIALS AND METHODS: Eleven patients (median age 1.3 years; range 5.1 months to 15.8 years) were investigated prospectively with 3D FISP MRA and spin-echo techniques. Additional diagnostic data were available from surgery (n=7), cardiac catheterization (n=5), CT (n=2), barium swallow (n=3) and bronchoscopy/oesophagoscopy (n=4). RESULTS: In one case, diagnosis was missed with low-resolution spin-echo sequences, but high-resolution 3D FISP MRA revealed a double aortic arch. 3D FISP MRA accurately found (n=8) or excluded (n=3) vascular rings or slings in all patients. Using a five-level grading system for 3D FISP MRA image quality (1=non-diagnostic; 5=excellent), the mean grade was 4.3+/-0.7 with no significant grade difference between two independent observers (P=0.81). CONCLUSIONS: High-resolution 3D FISP MRA accurately defined or excluded vascular rings and slings in patients with respiratory symptoms and/or dysphagia. This technique may provide a non-invasive, radiation-free alternative without contrast agents for diagnosis of vascular rings and slings in free-breathing infants and children.
BACKGROUND:Congenital upper airway obstruction and dysphagia may be caused by vascular rings and slings. Often, invasive and radiation-dependent diagnostic procedures are needed to clarify the diagnosis. OBJECTIVE: To evaluate the diagnostic utility of high-resolution, free-breathing three-dimensional double-slab fast imaging with steady precession magnetic resonance angiography (3D FISP MRA) in infants and children with respiratory upper airway obstruction and/or dysphagia for detection or exclusion of vascular rings and slings. MATERIALS AND METHODS: Eleven patients (median age 1.3 years; range 5.1 months to 15.8 years) were investigated prospectively with 3D FISP MRA and spin-echo techniques. Additional diagnostic data were available from surgery (n=7), cardiac catheterization (n=5), CT (n=2), barium swallow (n=3) and bronchoscopy/oesophagoscopy (n=4). RESULTS: In one case, diagnosis was missed with low-resolution spin-echo sequences, but high-resolution 3D FISP MRA revealed a double aortic arch. 3D FISP MRA accurately found (n=8) or excluded (n=3) vascular rings or slings in all patients. Using a five-level grading system for 3D FISP MRA image quality (1=non-diagnostic; 5=excellent), the mean grade was 4.3+/-0.7 with no significant grade difference between two independent observers (P=0.81). CONCLUSIONS: High-resolution 3D FISP MRA accurately defined or excluded vascular rings and slings in patients with respiratory symptoms and/or dysphagia. This technique may provide a non-invasive, radiation-free alternative without contrast agents for diagnosis of vascular rings and slings in free-breathing infants and children.
Authors: Elmar Spuentrup; Warren J Manning; Peter Börnert; Kraig V Kissinger; René M Botnar; Matthias Stuber Journal: Radiology Date: 2002-11 Impact factor: 11.105
Authors: Thomas Sangild Sørensen; Hermann Körperich; Gerald F Greil; Joachim Eichhorn; Peter Barth; Hans Meyer; Erik Morre Pedersen; Philipp Beerbaum Journal: Circulation Date: 2004-06-21 Impact factor: 29.690
Authors: G F Greil; I Wolf; A Kuettner; M Fenchel; S Miller; P Martirosian; F Schick; M Oppitz; H-P Meinzer; L Sieverding Journal: Clin Res Cardiol Date: 2007-01-22 Impact factor: 5.460
Authors: Frances M Mitchell; Sanjay K Prasad; Gerald F Greil; Peter Drivas; Vassilios S Vassiliou; Claire E Raphael Journal: World J Clin Pediatr Date: 2016-02-08