title: Useful signs for the assessment of vascular rings on cross-sectional imaging.
abstract: Vascular rings can be challenging to diagnose because they can contain atretic portions not detectable with current imaging modalities. In these cases, where the compressed airway and esophagus are not encircled by patent, opacified vessels, there are useful secondary signs that should be considered and should raise suspicion for the presence of a vascular ring. These signs include a double aortic arch, the four-vessel sign, the distorted subclavian artery sign, a diverticulum of Kommerell, a ductal diverticulum contralateral to the aortic arch, and a descending aorta contralateral to the arch or circumflex aorta. If none of these findings is present, a ring can be excluded with confidence.
authors.affiliation: Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA. sgould@nemours.org.
authors.forename: Sharon W
authors.initials: SW
authors.lastname: Gould
authors.affiliation: Medical Imaging, Ann and Robert H. Lurie Children's Hospital, 225 East Chicago Ave., Chicago, IL, 60611, USA.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Rigsby
authors.affiliation: Pediatric Radiology, Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA.
authors.forename: Lane F
authors.initials: LF
authors.lastname: Donnelly
authors.affiliation: Pediatric Cardiology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: McCulloch
authors.affiliation: Pediatric Cardiac Surgery, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE, 19803, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Pizarro
authors.affiliation: Medical Imaging, Nemours Children's Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Epelman
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities*; D001015:Aortic Arch Syndromes / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D013348:Subclavian Artery / Q000002:abnormalities*; D054079:Vascular Malformations / Q000175:diagnosis*
keywords: Aorta; Aortic anomaly; Children; Computed tomography; Magnetic resonance imaging; Vascular ring