永存第5对主动脉弓的比较影像学及新分型探讨

Comparative imaging and new classification approach of persistent fifth aortic arch

目的:分析和比较永存第5对主动脉弓(PFAA)的超声心动图及多层螺旋CT血管成像的图像特征并探讨本病的新分型法。方法:回顾性分析3例PFAA的超声心动图及CT图像特征,依据当前分型法及新的改良分型法进行分类。结果:3例PFAA包括新分型A1型(Weinberg-A型)、新分型A2型(Weinberg-B型)和A3型(头臂动脉异常起源)各1例,螺旋CT血管造影可清晰显示3例PFAA的空间结构及病理解剖,超声心动图能显示2例A1型和A2型的结构及血流动力学变化,1例A3型超声漏诊。结论:超声心动图及CT对诊断PFAA具有重要价值,二者联合应用能更准确评价PFAA病理解剖及血流动力学。新的分型方法包含了更全面的PFAA类型,有利于系统分析。

Objective：To approach the diagnostic accuracy of echocardiography,multi-slice spiral CT angiography（MSCTA） of persistent fifth aortic arch（PFAA） and modify the description of PFAA by developing a new classification system.Methods：Echocardiogram and MSCTA of three selected PFAA cases were retrospectively analyzed with the current classification and the new classification.Results：One case of type A1（type Weinberg-A）,one case of type A2（type Weinberg-B） and one case of type A3（abnormal origin of brachiocephalic artery） could be visualized clearly and directly by MSCTA.Morphology of PFAA and its flow disturbance could be seen on echocardiogram in cases of type A1 and type A2,although the other case of type A3 was miss diagnosed due to ignoring the suprasternal views.Conclusions：The anatomical and hemodynamic characteristics of PFAA can be accurately diagnosed by echocardiography combined with MSCTA.This new classification includes all of the potential PFAA and facilitates their analysis.