Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Congenital Pyriform Aperture Stenosis
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Interrupted left pulmonary artery

Case Detail

Anatomy: Chest
Borders
Heather Borders, MD
Diagnostic Category: Developmental or Congenital
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
Adobe32 PDF Imagej32 ImageJA

History

7 month old female referred for an abnormal outside echo with inability to see a left pulmonary artery


Case Images


Diagnosis

Interrupted left pulmonary artery

Findings

Absent left main pulmonary artery, small left hemithorax with ipsilateral mediastinal shift, multiple collateral vessels in the left hilum and mediastinum, right aortic arch with mirror image branching.

Discussion

Proximal interruption of the pulmonary artery is when there is unilateral absence of a central pulmonary artery in the setting of a formed ipsilateral lung. This anomaly likely is due to abnormal development of the sixth aortic arch. The affected side typically is opposite the aortic arch, as in this case. The peripheral ipsilateral pulmonary arteries are supplied by systemic collateral arteries.

Proximal interruption of the pulmonary artery may be associated with other cardiovascular anomalies. At chest radiography and CT, the ipsilateral lung usually appears small, a finding likely due to hypoplasia, and the contralateral lung appears hyperlucent and hyperexpanded. Ipsilateral shift of the mediastinum is present. Radiographic findings may include ipsilateral absent or diminutive appearance of the pulmonary hilum, ipsilateral narrowed intercostal spaces, and, occasionally, rib notching.

CT findings include nonvisualization of the ipsilateral central pulmonary artery, reconstitution of more peripheral pulmonary arteries from collateral vessels, and linear areas of opacification perpendicular to the pleura, a finding thought to represent transpleural collateral blood vessels.

Reference

Dillman JR, Sanchez R, Ladino-Torres MF et al. Expanding upon the Unilateral Hyperlucent Hemithorax in Children. RadioGraphics (2011); 31: 723-741.



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare