There are three main types of IAA (A, B, and C), which were defined in 1959 according to the anatomical site of the aortic interruption ( 2). Interrupted aortic arch (IAA) is a rare condition that is defined as a lack of luminal continuity between the ascending and descending portions of the Aorta ( 1). What makes this case report more important is that the authors believe that diagnostic methods in developed countries are able to diagnose this congenital heart disease sooner in neonatal or even in prenatal periods, resulting in a lower incidence of presentation of similar cases in childhood.Ĭardiac Imaging CT-Angiography Pediatrics 1. The symptoms intensified after repairing the patient’s ventricular septal defect (VSD) however, definite diagnosis was obtained by CT angiography. Explanation of this case could be helpful and attractive since echocardiographic and angiographic findings were not definitive enough for final diagnosis of this case. The reason why our case is type C could be explained from an embryologic point of view. Interestingly, almost all types of right sided aortic arch interruptions reported so far were of type B. The computed tomography (CT) angiographic findings revealed type C aortic arch interruption with right sided aortic arch which is a very rare condition and only one similar case has been previously reported in the literature. The patient was referred to our radiographic center and preceeded to undergo CT angiography with multislice spiral thin section scans plus maximum intensity projection (MIP), multiplanar reconstruction (MPR) and volume rendering techniques. Although in all those evaluations, right sided aortic arch (RSAA) and increased right ventricle (RV) and pulmonary artery (PA) pressures were noticed, the definite diagnosis was not reached at that occasion. Long-term examination of the disorder was started by echocardiography since he was one-month old and was performed when he was 2 years old. Use of volume reconstruction may promote its clinical usage and help prenatal diagnosis.ī-flow STIC fetal echocardiography interrupted aortic arch spatiotemporal image correlation.A 4- year old boy with a history of poor feeding, dyspnea and irritability while feeding that started since infancy, was referred to our center. It is demonstrated that IAA-A could be diagnosed by traditional fetal echocardiography, while 4D technique could better display the anatomic structure and the spatial relationships of the great arteries. 4D BF-STIC-sagittal and 4D BF-STIC-4CV were better than traditional 2D ultrasound in detecting the aortic arch and neck vessels between 17 and 28 gestational weeks and 29 to 40 gestational weeks in normal fetuses. A significantly enlarged MPA combined with symmetric ventricles was found in the IAA-A fetuses, while the size of the VSD was negatively correlated with RV/LV ratio. Six subgroups were evaluated according to gestational age.įetal 2DE, 4D BF-STIC-sagittal, and 4D BF-STIC-4CV made the correct prenatal diagnosis of IAA-A in 19/23 (82.6%), 14/21 (66.7%), and 19/21 (90.5%) of patients, respectively. ![]() Fetal 2DE, 4D BF-STIC-sagittal, and 4D BF-STIC-4CV were used to visualize the aortic arch and its associated neck vessels. RV/LV and MPA/AAO ratios were calculated and compared with that of IAA-A fetuses. An additional 183 normal fetuses were also included in our study. 4D BF-STIC was performed in 21 fetuses using the sagittal view (4D BF-STIC-sagittal) and the four-chamber view (4D BF-STIC-4CV) as initial planes of view. The fetal echocardiography image data were reviewed to analyze the ratio of right ventricle to left ventricle (RV/LV) diameter, the ratio of main pulmonary artery to ascending aorta (MPA/AAO) diameter, and the correlation of RV/LV diameter ratio and size of ventricular septal defect (VSD). Twenty-three cases of confirmed IAA-A identified by fetal echocardiography were involved in the study. The purpose of our report is to evaluate the use of two-dimensional echocardiography (2DE) and 4D echocardiography with B-flow imaging and spatiotemporal image correlation (4D BF-STIC) in detecting IAA type A (IAA-A). Fetal interrupted aortic arch (IAA) is a rare cardiac anomaly and its prenatal diagnosis is challenging.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |