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肺动脉闭锁伴室间隔缺损的多层螺旋CT诊断

Multislice CT Findings of Pulmonary Atresia with Ventricular Septal Defect

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【作者】 杨敏洁夏黎明江文涛周燕发王仁法肖明宋金梅赵金平潘铁成程佩萱

【Author】 YANG Min-jie,XIA Li-ming,JIANG Wen-tao,et al.Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,P.R.China

【机构】 华中科技大学同济医学院附属同济医院放射科武汉钢铁公司第二医院放射科华中科技大学同济医学院附属同济医院心胸外科华中科技大学同济医学院附属同济医院儿科 430030武汉430030武汉430085武汉

【摘要】 目的:回顾性分析肺动脉闭锁伴室间隔缺损(PAVSD)的多层螺旋CT(MSCT)表现。方法:分析5例肺动脉闭锁伴室间隔缺损患者的MSCT图像。4例行平扫及双期扫描,另1例行单期扫描。结合薄层图像、多平面重组、薄层最大密度投影以及容积再现法进行观察。结果:MSCT显示肺动脉瓣闭锁2例,肺动脉干中断、无中央共汇者3例。5例均见室间隔缺损。2例见明显的支气管动脉扩张;2例见直接主动脉肺动脉侧支;2例见间接主动脉肺动脉侧支。1例合并右心室发育不良及三尖瓣狭窄,1例合并房间隔缺损;3例合并右位主动脉弓,2例合并主动脉后左无名静脉。1例有手术史者可见上腔静脉与右肺动脉吻合,与右心房无交通。结论:MSCT可清楚地显示PAVSD的主要表现。

【Abstract】 Objective:To describe multislice CT findings of pulmonary atresia with ventricular septal defect (PAVSD).Methods:Non-contrast enhanced MSCT scans and biphasic contrast enhanced MSCT scans (n=4) and a monophasic contrast enhanced MSCT scan of five patients with PAVSD were retrospectively evaluated.The presence and location of pulmonary atresia,the presence of central confluences,the presence,origin,course and distribution of aorto-pulmonary collateral vessels and the patterns of intrapulmonary arteries were evaluated with reformatted thin-slice images,MPR and thin-slab MIP on MSCT.Associated anomalies,varieties and postoperative changes when there was a history of surgery were also noted.Results:The central pulmonary arteries and central confluences could be identified in 2 patients with pulmonary valvular atresia while no central pulmonary arteries and central confluences were noted in the other 3 patients.Ventricular septal defect (VSD) was identified in 5 patients.Collateral arteries from bronchial arteries,direct and indirect aortopumonary collateral vessels were identified each in 2 patients,respectively.A hypoplastic right ventricle combined with tricuspid stenosis (n=1),atrial septal defect (ASD) (n=1),right aortic arch (n=3) and postaortic left innominate vein (n=2) were also noted.Anastomosis of superior vena cava and right pulmonary artery was identified in one patient with a history of surgery.Conclusion:Main MSCT findings of PAVSD include pulmonary valvular atresia or absence of central pulmonary arteries and/or central confluences,VSD,collateral arteries of varied origin,course and distribution and associated anomalies and varieties such as right ventricle hypoplasia,ASD,right aortic arch and postaortic left innominate vein.

  • 【文献出处】 放射学实践 ,Radiologic Practice , 编辑部邮箱 ,2005年06期
  • 【分类号】R816.2
  • 【被引频次】14
  • 【下载频次】146
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