Chopra Mark,  Barrett Hannah,  Hutchinson J.,  Kiho Liina,  Arthurs Owen

Final Pr. ID: Poster #: CR-012

Ductus Arteriosus calcification is a poorly comprehended pathology occasionally reported on chest radiographs, more commonly on CT. The purpose of this educational abstract is to present the concepts surrounding ductal arteriosus (DA) calcification and reviews the literature to date.
We retrospectively searched the main medical literature (PubMed, MEDLINE, CINAHL and Google scholar databases) using the following keywords: “ductus arteriosus”, “ligamentum arteriosum”, “calcification”, “ductal”, “patent ductus arteriosus”, “children”, “paediatric”. Articles regarding ductus arteriosus calcification were further evaluated for citations.

Sixteen articles were found which dated back over nearly a century. Of these eight concerned a paediatric population and very few had histological confirmation. The majority highlighted that ductal calcification is more prevalent than previously thought. Ductal calcification was initially reported on the chest roentgen-ray in 1931 by Weiss. The increasing prevalence has been compounded by the use of the greater spatial resolution offered by modern CT scanners. A study in 2012 showed up to a third of children have ductal calcification on CT, with peak incidence is towards the end of the first decade in girls. There is conflicting opinion regarding the pathophysiology of ductal calcification, which may be either ductal aneurysmal thrombus regression, or more likely ligamentum arteriosum intimal and medial wall calcification.

This literature review illustrates the general paucity of histological data and suggests that the autopsy evidence favours intimal and medial wall calcification. Read More

Authors:  Chopra Mark , Barrett Hannah , Hutchinson J. , Kiho Liina , Arthurs Owen

Keywords:  Ductus arteriosus calcification, ligamentum arteriosum

Chopra Mark,  Barrett Hannah,  Hutchinson J.,  Kiho Liina,  Arthurs Owen

Final Pr. ID: Poster #: CR-013

Ductus Arteriosus calcification is a relatively common, typically unreported feature on plain film radiography. The more recent literature quotes a prevalence on unenhanced CT of between 37-61% of children and a peak at the age of 6-10 years. Adult studies have shown that calcification of the ligamentum arteriosum can occur alone or be associated with atherosclerotic and/or granulomatous calcification. We report two cases in whom they were identified as incidental findings on forensic post mortem CT, for whom we obtained histological confirmation.

Case 1: An 8 month old child who died in non-suspicious circumstances had incidental ductal arteriosus calcification reported on post mortem CT, following unremarkable skeletal survey. Intimal mural calcification was reported on histology at autopsy.

Case 2: A 19 month old child who died of aspiration underwent full skeletal survey and PMCT as part of the pre-autopsy imaging assessment. The skeletal survey revealed incidental ductus arteriosus calcification, initially reported as PDA clip, with correlation at CT. Intimal and medial mural calcification was reported on histology at autopsy.

These cases showed that ductal calcification was intimal and medial in nature. This is consistent with the current literature regarding mural calcification rather than thrombus regression calcification. Read More

Authors:  Chopra Mark , Barrett Hannah , Hutchinson J. , Kiho Liina , Arthurs Owen

Keywords:  Ductus arteriosus calcification, Post mortem, Non-accidental injury