Abstract
OBJECTIVE: To investigate the clinical utility of computed tomography (CT) in the quantitative evaluation of pediatric tracheal morphology in the context of pulmonary artery sling surgery. METHODS: A retrospective analysis was performed on 17 pediatric cases diagnosed with pulmonary artery sling at Fujian Children's Hospital between April 2021 and May 2025. CT imaging data were reconstructed and quantitatively analyzed to objectively evaluate tracheal morphological changes pre- and post-operatively. RESULTS: Both ultrasound and CT can accurately detect pulmonary artery slings. Among the various noninvasive methods available for assessing tracheal morphology and obtaining quantitative measurements, we rely more heavily on CT. In this study, 12 of the 17 pediatric patients underwent postoperative CT follow-up. Quantitative CT assessment of the trachea in these 12 patients before and after surgery demonstrated improvement in tracheal narrowing postoperatively compared with preoperative status, as measured by both diameter and cross-sectional area. Postoperative narrow-to-wide ratios increased, and tracheal carina angles decreased. The diameter-based NWR increased from 0.41 ± 0.17 to 0.73 ± 0.12; the area-based NWR increased from 0.22 ± 0.19 to 0.52 ± 0.13; and the tracheal carina angle decreased from 120.32° ± 10.58°to 77.11° ± 10.60°. All observed differences were statistically significant (p < 0.001). CONCLUSIONS: CT imaging serves as a comprehensive diagnostic tool, enabling the identification of pulmonary artery slings as well as the detection of associated cardiovascular anomalies and tracheal abnormalities, thereby facilitating preoperative surgical planning. Furthermore, quantitative CT analysis of tracheal morphology both pre- and post-surgery provides a more precise and objective evaluation of tracheal changes.