CAJ | 학술논문

肺动静脉瘘是由先天性发育不全导致的肺动静脉间异常交通，产生心外右向左分流，临床表现为劳力性呼吸困难、咯血、气促、发绀等症状。本文报道1例弥漫性肺动静脉瘘患者的诊疗经过，首次行肺动脉血管造影（ CTA）未见异常，复查发现左肺门区、右肺上叶及下叶部分血管走行呈“逗点样”改变，局部肺动静脉间见细条状交通支。肺动静脉瘘患者CT检查可能会出现漏诊，对于难以明确的低氧血症者，应考虑肺动静脉瘘可能，选择恰当的扫描时相及造影剂剂量行肺动脉CTA，并结合患者临床表现、实验室检查结果，即可做出明确诊断。
폐동정맥루시유선천성발육불전도치적폐동정맥간이상교통，산생심외우향좌분류，림상표현위로력성호흡곤난、각혈、기촉、발감등증상。본문보도1례미만성폐동정맥루환자적진료경과，수차행폐동맥혈관조영（ CTA）미견이상，복사발현좌폐문구、우폐상협급하협부분혈관주행정“두점양”개변，국부폐동정맥간견세조상교통지。폐동정맥루환자CT검사가능회출현루진，대우난이명학적저양혈증자，응고필폐동정맥루가능，선택흡당적소묘시상급조영제제량행폐동맥CTA，병결합환자림상표현、실험실검사결과，즉가주출명학진단。
Pulmonary arteriovenous fistulas is abnormal connection between pulmonary arteries and veins , which causes extracardiac right -to -left shunt.The disease is induced by congenital aplasia .Its clinical manifestations include exertional dyspnea , hemoptysis, short of breath and cyanosis .The article made a case report of the diagnosis of a patient with diffuse pulmonary arteriovenous fistulas .We observed no abnormality in the first CTA .In reinspection , we noted "comma sign"in the blood vessel trend in the hilar zone of the left lung and the superior lobe and inferior lobe of the right lung , and we also observed strip-like ramus communicans between partial pulmonary arteries and veins .Missed diagnosis may happen in the CT examination of patients with pulmonary arteriovenous fistulas .If hyoxemia can not be definitely diagnosed , the possibility of pulmonary arteriovenous fistulas should be considered .Proper time phrase for scaning and dose of contrast agent should be chosen to conduct CTA , and clinical manifestations and laboratory examination results should be analyzed together , in order to make definite diagnosis .