【摘要】 目的 探讨永存动脉干Ⅳ型的CT血管造影特征。方法 回顾性分析CT血管造影证实的永存动脉干Ⅳ型共14例,男5例,女9例;评估心脏形态、室间隔缺损、动脉干骑跨、支气管动脉异常及侧支循环、其他心血管畸形特征。结果 CT血管造影显示:(1)双心室增大明显,伴右心房增大;(2)高位室间隔缺损,缺损平均直径(20.1±5.2) mm,其中男性为(23.7±5.2) mm,女性为(18.2±5.6) mm,差异无统计学意义(t=1.813,P=0.095,P>0.05);(3)动脉干骑跨率为(50±5.2)%,男性为(51±2.3)%,女性为(49±6.3)%,差异无统计学意义(t=0.522,P=0.611,P>0.05);动脉干平均内径(34.2±6.4)mm,男性为(39.1±4.3)mm,女性为(31.4±5.8) mm,差异有统计学意义(t=2.589,P=0.024,P<0.05);(4)无肺动脉主干,心腰明显凹陷,肺血由支气管动脉及侧支循环供应,部分支气管动脉呈“残根”征;(5)男女各2例伴右位主动脉弓,其中1例男性有左侧肺静脉异常粗大,女性1例伴永存左上腔静脉。结论 永存动脉干Ⅳ型特征复杂多变,CT血管造影有利于提高诊断准确率,对手术有重要参考价值。更多还原

【Abstract】 Objective To evaluate the findings of computed tomography angiography of persistent truncus arteriosus Ⅳ.Methods14 patients(5 men and 9 women) of persistent truncus arteriosus Ⅳ confirmed by CT angiography were involved in this study.The cardiac morphology,ventricular septal defect,arteriosus truncus straddle,anomalism bronchial arteries and complicating vascular malformations were analysed retrospectively.Results CT angiography showed:(1)Biventricular enlargement obviously and accompanying with right atrium enlargement;(2)The average diameter of ventricular septal defect was(20.1±5.2) mm,(23.7±5.2) mm in men and(18.2±5.6) mm in women,there was no statistically signfificant difference between them(t=1.813,P=0.095,P>0.05);(3)The average rate of the arteriosus truncus straddle was(50±5.2) %,(51 ± 2.3) % in men and(49±6.3) % in women,there was no statistically significant difference between them(t=0.522,P=0.611,P> 0.05);the average diameter of arteriosus truncus was(34.2±6.4) mm,(39.1 ±4.3) mm in men and(31.4±5.8) mm in women,there was statistically difference is significant between them(t=2.589,P=0.024,P<0.05);(4)No main pulmonary artery and the umbilication of cardiac waist was obivious,the lungs were feeded by collateral circulation and bronchial arteries;(5)The lesions accompanied with right sided aortic arch in 2 cases,of them,one man accompanied with left pulmonary veins thickness and one woman accompanied with persistent left superior vana cava.Conclusion The characters of the persistent truncus arteriosus Ⅳ are complicated and varied,CT angiography is benefit for diagnosis and administration of operation of this disease.更多还原