螺旋CT增强扫描及血管造影诊断肺隔离症的价值

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目的探讨螺旋CT增强扫描及血管造影对显示肺隔离症供血血管的价值。方法回顾性分析经手术和病理证实的18例肺隔离症患者的影像学资料。结果18例术前均做了CT平扫与增强、血管造影(主要采用最大密度投影法)检查。18例肺隔离症中,14例为肺叶内型,4例为肺叶外型。病灶12例位于左肺下叶,6例位于右肺下叶。CT平扫示降主动脉后方或右肺下叶软组织密度肿块11例,囊肿样病变7例,病灶周围伴有肺气肿。增强CT显示了13例供血动脉。而血管造影明确显示了16例异常供血动脉,其中自发于胸主动脉10例,腹主动脉3例,冠状动脉1例,肋间动脉2例。此与术中所见的血管起源、走行和形状基本一致。结论螺旋CT增强扫描和螺旋CT血管造影能很好地显示肺隔离症的异常供血动脉,此有利于确诊该病和制订手术治疗方案。

Objective To evaluate efficacy of enhanced CT scan and angiography in displaying supplying vessels in pulmonary sequestration. Methods 18 patients that had been proven pulmonary sequestration by operation and pathology were retrospectively reviewed with their imaging findings. All 8 patients underwent plain and enhanced CT scan and angiography （SPCT method）, principally using maximum intensity projection （MIP）. Results 14 patients displayed intralobar sequestration, and 4 extralobar sequestration. 12 patients had lesions in left lower lung and 6 in right lower lung. Plain CT scan found that 11 patients had soft-tissue mass behind descending or in right lower lung, and 7 had cyst-like lesions. Emphysema was seen around the pulmonary sequestration. Enhanced CT scan displayed supplying vessels in 13 cases, and angiography presented 16 cases who had abnormal supplying vessels, among which 10 were from thoracic aorta, 3 from abdominal aorta, 1 from coronary artery and 2 from intercostal arteries, the same as that was seen during operation. Conclusion Enhanced CT scan and angiography （SCTA） can well display abnormal supplying vessels for pulmonary sequestration, contributing to planning surgical resolutions.