Vascular rings in symptomatic children: frequency of chest radiographic findings.

PURPOSE: To determine the relative frequency of radiographic findings in symptomatic children with vascular rings.

MATERIALS AND METHODS: Preoperative chest radiographs in 41 children (mean age, 21 months) with surgically proved vascular rings were retrospectively analyzed. There were 41 frontal and 39 lateral radiographs. Lateral views were evaluated for retrotracheal opacity, tracheal narrowing, and anterior tracheal bowing. The aortic arch, descending aorta, and tracheal indentation were assessed on frontal views.

RESULTS: Findings on 39 lateral radiographs included increased retrotracheal opacity on 31 (79%), anterior tracheal bowing on 36 (92%), and tracheal narrowing on 30 (77%) radiographs. All findings were present on 24 (62%) radiographs. Findings on 41 frontal radiographs included right aortic arch on 35 (85%), distal tracheal indentation on 30 (73%), and right descending aorta on 27 (66%) radiographs. All findings were present on 20 (49%) radiographs. Four (10%) frontal radiographs were normal or indeterminate. The combination of frontal and lateral views showed at least one abnormality in every patient. No symptomatic patient with a vascular ring had a normal radiograph.

CONCLUSION: A normal chest radiograph is evidence against the presence of a vascular ring in symptomatic children. Both lateral and frontal radiographs are important in diagnosis.