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Introduction: Calcification of the ductus and ligamentum Botalli with no cardio-respiratory symptoms is normally a sign of their closure. However, as the calcification can be associated with a patent duct or a ductal aneurysm, its presence must not be misinterpreted. The frequency and the different patterns of this calcification must be known, as well as is diagnostic relevance. It is also important to differentiate it from other types of upper mediastinal calcification., Material and Methods: Thirty-two cases of ducts Botalli calcification were collected over 16 years, during which time period 38,476 children (24,095 males, 14,381 females) were submitted to chest radiography. Patient populations were divided into the following age-groups: preterms-newborns; 2-3 months; 4-6 months; 7-12 months; 2-3 years; 4-6 years; 7-10 years; 11 years on. We studied the ductus Botalli according to the following parameters; conspicuity, location, size and shape of the calcification; prevalence of the radiographic finding in 1,000 patients by gender and age; persistence of the finding in follow-up examinations., Results: The calcification was found in left mediastinal site at the posterior aspect of the 4-6th ribs, ranging 1-6 mm in length, and 1-4 mm in width. It had a round, comma-like or elongated shape. In all, 32 cases of ductal calcification (.83/1000) were found: 14 (44%) were in males (age range 7 months-12 years), 18 (56%) in females (age range 11 months-10 years). Age range analysis shows that the calcification is distributed more evenly in the male population with the highest number of calcified ducts (5 = 94/1000) found in the 4-6 year age group and a relative prevalence in the age group 7-12 months (2 cases = 1.05/1000). A marked prevalence is found in females 4-6 years old (11 cases = 3.8/1000). The duct calcification was an occasional finding during chest radiography for other, more severe conditions in 9 of 14 males and in 6 of 18 females., Conclusions: No data can be found in the literature on the frequency of ductus Botalli calcification at chest radiography: our results indicate it to be less than 1/1000 (.83/1000). We have found a prevalence of ductus calcification (1.25/1000) in females even though females are less numerous in our population. The ductal calcification is often associated with severe, mostly hematologic, diseases. We believe that the conspicuity of the calcification is due to its density more than to its shape and size. Literature data indicate that ductus calcification may still be visible 6 months to 8 years after its discovery: our results, although on a small series, confirm this observation. The clinical significance of the calcification is still unclear.

To characterize the ductus arteriosus shunt after birth, 53 normal newborn infants (36-41 weeks gestation), appropriate in size for gestational age, were examined using two dimensional Doppler echocardiography directed continuous Doppler for evidence of patent ductus arteriosus. The infants were examined within six hours of birth, and every six-eight hours thereafter until ductus arteriosus shunt could no longer be detected. In 51/53 infants, an adequate examination was possible and ductus arteriosus was detected in every infant using the standard precordial approach. Using two dimensional Doppler echocardiography a yellow-orange-red jet, sometimes blue in the central area, directed at the lateral wall of the pulmonary artery was recorded; using continuous Doppler a diastolic or continuous spectral flow into the main pulmonary artery was recorded. Ductus arteriosus shunt could no longer be detected in 7 infants 12 hours after birth, in 26 infants 12-24 hours after birth, in 11 infants 24-36 hours after birth, in 5 infants 36-48 hours after birth and in 2 infants 48-60 hours after birth. A diastolic spectral Doppler flow was present in 38 infants and became continuous before duct closure in 27 infants. In 13 infants it was continuous at first examination and until the ductus arteriosus closure. Both diastolic or continuous spectral Doppler flow could present a flat waveform profile, or a protodiastolic or protosystolic peak velocity. The shunt peak velocity increased significantly with the age i.e. (1.5 +/- 0.7 m/sec mean and SD-), at first examination, vs 2.3 +/- 0.6 m/sec at last examination before ductus arteriosus closure (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)