Abstract：
To investigate the relationship between quantitative tracheal geometry and clinical course among various types of vascular ring and to identify factors correlating with symptom presentation. Patients with vascular ring diagnosed between April 2010 and December 2022 were included. All the patients were classified as type 1 (complete double aortic arch); type 2 (incomplete double aortic arch); type 3 (circumflex aorta); type 4 (right aortic arch and aberrant left subclavian artery with a left retroesophageal diverticulum of Kommerell); or type 5 (mirror-imaged right aortic arch with retroesophageal aortic diverticulum). Their clinical characteristics and quantitative variables on computed tomography (CT) were compared. Of the 50 patients enrolled, those with type 1 tended to have a smaller luminal tracheal diameter at the level of the ring. The median symptom-free survival time was shortest in this group (16.0 days [95% confidence interval (CI): 9.4-51.0]), followed by type 3 (138.0 days [95% CI: 0.0-851.4]). Type 1 (hazard ratio [HR]: 9.0; 95% CI: 2.3-35.0; P = 0.001), type 3 (HR: 4.2; 95% CI: 1.4-13.2; P = 0.013), and the percentage of tracheal narrowing in the anteroposterior projection (HR: 0.87; 95% CI: 0.78-0.96; P = 0.008) were significantly associated with symptom presentation in the time-dependent course. The aortic arch encircling the entire circumference in type 1 and high-pressure vasculature in front of the vertebral body in types 1 and 3 may contribute to raising the risk of symptom presentation.
摘要：
探讨不同类型血管环的定量气管几何形状与临床病程之间的关系，并确定与症状表现相关的因素。纳入2010年4月至2022年12月期间诊断为血管环的患者。所有患者均分为1型（完全双主动脉弓）；2型（不完全双主动脉弓）；3型（回旋主动脉）；4型（右主动脉弓和异常左锁骨下动脉伴左食管后憩室）；或5型（镜像右主动脉弓伴食管后憩室）。比较了它们的临床特征和计算机断层扫描（CT）的定量变量。在50名患者中，1型的人倾向于在环的水平处具有较小的管腔气管直径。该组的中位无症状生存时间最短（16.0天[95％置信区间（CI）：9.4-51.0]），其次是类型3（138.0天[95%CI：0.0-851.4]）。类型1（危险比[HR]：9.0；95％CI：2.3-35.0；P=0.001），类型3（HR：4.2；95%CI：1.4-13.2；P=0.013），和气管狭窄在前后投影的百分比（HR：0.87;95％CI：0.78-0.96;P=0.008）与时间依赖性过程中的症状表现显着相关。1型主动脉弓环绕整个圆周，1型和3型椎体前方的高压脉管系统可能会增加症状出现的风险。
