I am writing in reference to the article titled “Vascular rings – what has changed, and what do I need to know as a practitioner?,” published in the April 2025 issue of CTY. ^{Reference Madira, Orr and Rosenblum1} I found the manuscript to be of great interest, offering significant insights into the radiological imaging of patients with vascular rings. While the paper is valuable, I would like to elaborate on certain aspects that could benefit from further investigation, particularly concerning patients with vascular rings.

This document serves as a review for physicians interested in visualising different types of vascular rings. It focuses on various imaging methods used for this anomaly, including esophagram. As the title suggests, modern cardiac radiological imaging methods have significantly changed diagnostic approaches. For instance, it is no longer necessary to subject patients to invasive imaging methods like esophagogastroduodenoscopy or the previously used esophagram.

Contemporary imaging modalities offer comprehensive visualisation with superior spatial resolution and three-dimensional capabilities, including the potential for three-dimensional CINE imaging. MRI of airways, especially with zero-echo time sequence, is a game-changer, especially for evaluating airway compression by adjacent vascular structures. Zero-echo time sequences are beginning to replace high-resolution CT and will do so completely in the future, thereby removing the barrier of radiation exposure.

Thanks to modern imaging methods, a bright future awaits even patients with airway obstruction caused by vascular rings.

Figure 1.

An example of airway imaging using a zero-echo time MR sequence in coronal plane. T – trachea.