Supplementary Material for: Assessment of Suspected Vascular Rings and Slings and/or Airway Pathologies Using Magnetic Resonance Imaging Rather Than Computed Tomography

<b><i>Background:</i></b> Congenital cardiovascular malformations (CCVM) may cause infrequently airway pathologies (AP) in children and are of prognostic and therapeutic relevance. While computed tomography (CT) is considered first-line imaging modality in many centres, we started using magnetic resonance imaging (MRI) more and more in the last years to detect CCVM and AP to avoid radiation in this patient group. <b><i>Objective:</i></b> The aim of this retrospective study was to determine and to compare the diagnostic accuracy of CT and MRI when used to detect CCVM and/or AP. <b><i>Methods:</i></b> All patients suspected to have CCVM and/or AP and examined either by CT or MRI between 2000 and 2013 in our hospital were included. Extension and type of CCVM, as well as their relationship to esophagus, trachea or bronchi were assessed and related to findings of tracheobronchoscopy, cardiac catheterization or surgery if available. <b><i>Results:</i></b> One hundred six patients (median [range] 4 years [2 days to 66 years]) were examined by CT (<i>n</i> = 27) or MRI (<i>n</i> = 79). In 78 patients (74%), CCVM and/or AP were found with either of the imaging methods. CCVM were found in 63 subjects. Forty-six of 63 subjects had both, CCVM and AP. The presence of CCVM was always detected correctly by CT or MRI, although both techniques had a weakness detecting atretic segments directly. AP (<i>n</i> = 61) were correctly diagnosed in all patients not intubated for artificial ventilation by CT (<i>n</i> = 17) and in all but 2 patients by MRI (39 out of 41). <b><i>Conclusions:</i></b> MRI is sensitive to detect CCVM associated with AP equally to CT without any radiation exposure.

<b><i>背景：</i></b> 先天性心血管畸形（Congenital cardiovascular malformations, CCVM）可在儿童群体中引发罕见气道病变（Airway Pathologies, AP），此类畸形具有重要的预后与临床治疗价值。尽管计算机断层扫描（Computed Tomography, CT）在多数医疗中心被视为一线影像学检查手段，但近年来我们逐渐更多采用磁共振成像（Magnetic Resonance Imaging, MRI）来检测CCVM与AP，以避免该患者群体暴露于电离辐射中。<b><i>目的：</i></b> 本回顾性研究旨在明确并比较CT与MRI在检测CCVM和/或AP时的诊断准确性。<b><i>方法：</i></b> 纳入2000年至2013年间于我院就诊、疑似罹患CCVM和/或AP且接受CT或MRI检查的所有患者。评估CCVM的累及范围与分型，及其与食管、气管或支气管的解剖关系，并将影像学结果与可行的气管支气管镜检查、心导管检查或手术结果进行对照。<b><i>结果：</i></b> 本研究共纳入106例患者，中位年龄为4岁（范围：2天至66岁），其中27例接受CT检查，79例接受MRI检查。通过两种影像学手段之一检出CCVM和/或AP的患者共78例，占比74%。其中63例患者检出CCVM，63例中有46例同时合并CCVM与AP。CT与MRI均可准确检出CCVM，但两种技术在直接识别闭锁节段时均存在局限性。对于AP病例（n=61），未接受人工通气气管插管的患者经CT检查（n=17）后均可被准确诊断；而MRI检查（n=41）仅漏诊2例，准确检出39例。<b><i>结论：</i></b> MRI在检出合并AP的CCVM方面灵敏度与CT相当，且无需使患者暴露于电离辐射。