Routine multi detector computed tomography evaluation of tracheal impairment compared to laryngo-tracheal endoscopy in children with vascular ring.
Pediatr Surg Int
; 34(8): 879-884, 2018 Aug.
Article
de En
| MEDLINE
| ID: mdl-29961107
ABSTRACT
PURPOSE:
The aim of this study is to compare free-breathing routine multi detector computed tomography (MDCT) and laryngo-tracheal (LT) flexible endoscopy in the evaluation of tracheal impairment in children with vascular ring (VR). MATERIALS ANDMETHODS:
We performed a retrospective and monocentric study of all patients with VR from 1997 to 2014. Clinical data included initial symptoms, type of surgery and clinical outcome. MDCT were blindly reviewed by two radiologists in consensus, independently of LT endoscopy results. Radiologic and endoscopic results were reviewed according to four criteria percentage of tracheal narrowing, distance of the compression from carina, presence of bronchial compression and signs of tracheomalacia (TM). Concordance was evaluated for each criterion with a Spearman coefficient.RESULTS:
From 1997 to 2016, 21 patients with a vascular ring were operated on, among which 57% by thoracoscopy double aortic arch (n = 14), Neuhauser anomaly (n = 4) and Right aorta + aberrant right subclavian artery (n = 3). 90% of them presented with respiratory symptoms among which 43% of stridor. Chest X-ray was suggestive of VR in 87% of the cases. MDCT images and LT endoscopy results were available and analyzed for nine patients. Concordance (Spearman correlation coefficient) was excellent for percentage and level of tracheal narrowing (1) and good for TM (0.79).CONCLUSION:
Free breathing routine MDCT is a reliable exam compared to LT endoscopy in the evaluation of tracheal impairment in children with VR. In case of respiratory symptoms (except stridor) and suggestive chest X-ray of VR, endoscopy could be avoided and routine MDCT alone performed.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Trachée
/
Bronchoscopie
/
Tomodensitométrie multidétecteurs
/
Anneau vasculaire
/
Larynx
Type d'étude:
Observational_studies
Limites:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Langue:
En
Journal:
Pediatr Surg Int
Sujet du journal:
PEDIATRIA
Année:
2018
Type de document:
Article
Pays d'affiliation:
France