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Tomography
Volume 4
Issue 2
10.18383/j.tom.2018.00015
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Tomography is published by MDPI from Volume 7 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Grapho, LLC.
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Interesting Images

Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant

by
Jeremy R. Burt
1,*,
Michael Valente
2,
Ali Agha
3,
Kimberly Beavers
1,
Joseph Limback
1,
Michael Fiorino
1,
Rebecca Vicenti
1,
Fiona Tissavirasingham
1,
Khurram Butt
4 and
Andrew R. Crofton
5
1
Department of Radiology, Florida Hospital Orlando, Orlando, FL, USA
2
Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
3
Department of Internal Medicine, University of Texas, Houston, TX, USA
4
Department of Internal Medicine, Florida Hospital Orlando, Orlando, FL, USA
5
Department of Physical Therapy, Adventist University of Health Sciences, Orlando, FL, USA
*
Author to whom correspondence should be addressed.
Tomography 2018, 4(2), 43-45; https://doi.org/10.18383/j.tom.2018.00015
Submission received: 9 March 2018 / Revised: 11 April 2018 / Accepted: 10 May 2018 / Published: 1 June 2018
Versions Notes

Abstract

Prenatal ultrasonography in the early third trimester showed an unusual branching pattern of the right aortic arch. Echocardiography performed 4 h after birth showed the right aortic arch with mirror-image branching, patent ductus arteriosus, and patent foramen ovale. Because the location of the ductus arteriosus was unclear on echocardiography, cardiovascular magnetic resonance imaging was performed 3 days after birth. Advanced techniques including contrast-enhanced time-resolved magnetic resonance angiography and 3D time-of-flight magnetic resonance angiography allowed accurate diagnosis of a vascular ring comprising ascending and descending aorta, right aortic arch with mirror-image branching, and diverticulum of Kommerell giving rise to a left ligamentum arteriosum. The infant had hiccups, but no other symptoms. The esophagram was negative for obstruction. The infant was closely monitored; however, she developed esophageal obstruction at 7 months of age because of the vascular ring. She underwent lysis of the left ligamentum arteriosum followed by aortopexy for relief of esophageal obstruction. This report shows the utility of neonatal cardiovascular magnetic resonance imaging to evaluate complex congenital aortic arch anomalies.
Keywords: Vascular ring; neonatal cardiac magnetic resonance imaging; right aortic arch; mirror-image branching; left ligamentum arteriosum; diverticulum of Kommerell; esophageal obstruction Vascular ring; neonatal cardiac magnetic resonance imaging; right aortic arch; mirror-image branching; left ligamentum arteriosum; diverticulum of Kommerell; esophageal obstruction

Share and Cite

MDPI and ACS Style

Burt, J.R.; Valente, M.; Agha, A.; Beavers, K.; Limback, J.; Fiorino, M.; Vicenti, R.; Tissavirasingham, F.; Butt, K.; Crofton, A.R. Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant. Tomography 2018, 4, 43-45. https://doi.org/10.18383/j.tom.2018.00015

AMA Style

Burt JR, Valente M, Agha A, Beavers K, Limback J, Fiorino M, Vicenti R, Tissavirasingham F, Butt K, Crofton AR. Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant. Tomography. 2018; 4(2):43-45. https://doi.org/10.18383/j.tom.2018.00015

Chicago/Turabian Style

Burt, Jeremy R., Michael Valente, Ali Agha, Kimberly Beavers, Joseph Limback, Michael Fiorino, Rebecca Vicenti, Fiona Tissavirasingham, Khurram Butt, and Andrew R. Crofton. 2018. "Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant" Tomography 4, no. 2: 43-45. https://doi.org/10.18383/j.tom.2018.00015

APA Style

Burt, J. R., Valente, M., Agha, A., Beavers, K., Limback, J., Fiorino, M., Vicenti, R., Tissavirasingham, F., Butt, K., & Crofton, A. R. (2018). Complex Vascular Ring Diagnosed on Cardiovascular MR in a 3-Day-Old Infant. Tomography, 4(2), 43-45. https://doi.org/10.18383/j.tom.2018.00015

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