Congenital Thoracic Vascular Anomalies and Associated Airway Diseases

Abstract

Congenital thoracic vascular anomalies encompass the obstruction of the normal vessels, persistence of the aberrant vessels, and anomalous connection of the thoracic aorta and its branches, thoracic systemic veins, pulmonary arteries, and pulmonary veins. A vascular ring occurs when the anomalous vessel surrounds and compresses the trachea, esophagus, or both. Although echocardiography is a primary imaging modality to evaluate the children with congenital thoracic vascular anomalies, computed tomography (CT) has emerged as a useful alternative imaging modality for these conditions. By virtue of the rapid technical innovations for superior temporal and spatial resolution and lower radiation exposure, multidetector CT (MDCT) can make a definite and conclusive diagnosis of congenital thoracic vascular anomaly, airway compression by the anomalous vessel, and concomitant airway anomaly. CT angiography with three-dimensional (3-D) image also provides straightforward and comprehensive anatomic information for the selection of appropriate treatment options and preoperative surgical planning for the patients with these anomalies. In this chapter, we describe pathogenesis, pathophysiology, and imaging of the congenital thoracic vascular anomalies and associated airway abnormalities and illustrate the CT findings of these conditions.