Ligamentum arteriosum calcification on paediatric postmortem computed tomography
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ORIGINAL ARTICLE
Ligamentum arteriosum calcification on paediatric postmortem computed tomography Natasha Davendralingam 1,2 & Susan C. Shelmerdine 3,4,5 & J. Ciaran Hutchinson 6 & Mark Chopra 7 & Hannah Barrett 6 & Amy Agahi 1,2 & Liina Palm 6 & Owen J. Arthurs 3,4,5 Received: 25 March 2020 / Revised: 5 July 2020 / Accepted: 7 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Ligamentum arteriosum calcification may be a normal finding in some children, although the frequency has not been well described. Objective To estimate the frequency of ligamentum arteriosum calcification in children at postmortem imaging. Materials and methods We conducted a single-centre retrospective review of paediatric postmortem CT and chest radiographic imaging over a 6-year period (January 2012 to December 2018). Two independent reviewers assessed the presence of calcification on imaging. We calculated descriptive statistical analysis of ligamentum arteriosum calcification frequency and association with age and gender. Results During the study period, 220 children underwent whole-body postmortem CT and 182 underwent radiographic imaging. The frequency was higher on postmortem CT than plain radiographs (67/220, 30.5% vs. 3/182, 1.6%) and was highest in children ages 1–7 years (53.6–66.7%), with gradual reduction in frequency in older children, and none in children older than 12 years. There was no gender predilection. Conclusion In the postmortem setting, ligamentum arteriosum calcification is a common finding in children 12 years, then an alternative
explanation should be sought, particularly if there are additional pathological findings in the chest. The ligamentum arteriosum calcification frequency derived from our study on postmortem CTs is similar to that of Hong et al. [6], who found a frequency of 37.8% on non-contrast CT in living children and 3.6% on paediatric radiography. Differences as compared to other studies could be a result of differences in CT equipment and sensitivity of the readers. In our study, we employed a CT slice thickness of 0.7 mm, whereas thicker slices might miss subtle calcifications leading to lower reported rates, e.g., 13.2% on CT in living children using 5–10-mm slices [3]. Hong et al. [6] utilised 3–5-mm slices, whereas Proisy et al. [5] used 2-mm slices. Our thinslice postmortem CT study is arguably the more sensitive assessment of ligamentum arteriosum compared to the other available papers on ligamentum arteriosum frequency in a paediatric cohort. The findings in the literature are summarised in Table 2 for ease of reference [3–6]. This means we were able to detect some fine punctate calcifications that would not have been detected utilising thicker collimation sections. However, it is unclear whether there were specific population differences in studies with a higher frequency of calcifications [5]. Only one other published study examined a postmortem paediatric cohort for ligamentum arteriosum calcification frequency [5]. Because patients are dece
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