CAJ | 학술논문

目的评价双源螺旋CT造影(DSCTA)诊断单侧肺动脉起源异常的影像价值.方法回顾性分析13例经DSCTA诊断单侧肺动脉起源异常患儿临床资料,男7例,女6例;年龄1月龄～18岁,中位年龄1.83岁.复习DSCTA图像特征,并对照超声心动图结果.CTA检查采用前瞻性心电门控扫描.结果 13例均经CTA明确诊断为右肺动脉起源异常,11例起自升主动脉近段,2例起自升主动脉远段.11例合并动脉导管未闭,7例合并主肺动脉间隔缺损、主动脉弓离断(A型)及动脉导管未闭,1例合并主动脉弓部发育不良,1例合并法洛四联症(TOF),5例合并主动脉右弓右降,1例合并迷走右锁骨下动脉,1例仅为右肺动脉起源于升主动脉.超声心动图诊断肺动脉起源异常8例,3例疑似右肺动脉走行异常,2例漏诊异常起源的右肺动脉.1例合并TOF,10例合并三尖瓣中-重度反流,5例合并主-肺动脉间隔缺损及主动脉弓离断.7例手术,术中所见与DSCTA一致,行肺动脉起源异常矫治及三尖瓣成形术,其中3例术中同时行主动脉弓离断和主-肺动脉间隔缺损并动脉导管未闭修复术;1例术后合并严重肺部感染死亡.结论 DSCTA影像检查在评价肺动脉起源异常疾病中具有显著应用价值.
목적 평개쌍원라선CT조영(DSCTA)진단단측폐동맥기원이상적영상개치.방법 회고성분석13례경DSCTA진단단측폐동맥기원이상환인림상자료,남7례,녀6례;년령1월령～18세,중위년령1.83세.복습DSCTA도상특정,병대조초성심동도결과.CTA검사채용전첨성심전문공소묘.결과 13례균경CTA명학진단위우폐동맥기원이상,11례기자승주동맥근단,2례기자승주동맥원단.11례합병동맥도관미폐,7례합병주폐동맥간격결손、주동맥궁리단(A형)급동맥도관미폐,1례합병주동맥궁부발육불량,1례합병법락사련증(TOF),5례합병주동맥우궁우강,1례합병미주우쇄골하동맥,1례부위우폐동맥기원우승주동맥.초성심동도진단폐동맥기원이상8례,3례의사우폐동맥주행이상,2례루진이상기원적우폐동맥.1례합병TOF,10례합병삼첨판중-중도반류,5례합병주-폐동맥간격결손급주동맥궁리단.7례수술,술중소견여DSCTA일치,행폐동맥기원이상교치급삼첨판성형술,기중3례술중동시행주동맥궁리단화주-폐동맥간격결손병동맥도관미폐수복술;1례술후합병엄중폐부감염사망.결론 DSCTA영상검사재평개폐동맥기원이상질병중구유현저응용개치.
Objective Evaluating the imaging value of dual source computer tomography angiography (DSCTA) in diagnosis of anomalous origin of one pulmonary artery.Methods Clinical data of 13 patients with anomalous pulmonary artery diagnosed with DSCTA were retrospectively analyzed,and compared with data of echocardiography examination.Results The anomalous pulmonary was clearly diagnosed with DSCTA,which all originated from ascending aorta (AAO).Thirteen cases presented with anomalous right pulmonary artery.Of the total,11 cases originated from the proximal AAO,and 2 cases originated from the distal AAO.One patient was only with anomalous origin of right pulmonary.11 were complicated with PDA,7 were complicated with aortopulmonary septal defect and interruption of aortic arch(A type),1 case was complicated with dysplasia of aortic arch,1 case was complicated with aberrant right subclavian arteries,1 case was complicated with tetralogy of fallot(TOF),and 5 were complicated with right-sided aortic arch and right-sided descending aorta.Eight cases with anomalous pulmonary were diagnosed with echocardiography,3 cases were suspected,and 2 cases were missed.One case was complicated with TOF,5 cases were complicated with aortopulmonary septal defect,interruption of aortic arch (A type) and patent ductus artery (PDA),and 10 cases were complicated with moderate-severe regurgitation of tricuspid.In the 7 operative patients,there were consistent with DSCTA,the anomalous pulmonary and the complicated deformities were rectified.Conclusion DSCTA owns a high value in diagnosis of anomalous origin of pulmonary artery and complicated abnormities by clearly developing the pathologic anatomic features and cardiovascular malformations.