一种少见肺血管畸形的螺旋CT表现及其命名探讨(附4例报告)

A rare vascular malformation of the lung:discussion of the CT findings and nomenclature

目的描述一种少见肺血管畸形的螺旋CT表现并对其命名进行探讨。方法分析4例左下肺基底段动脉局限性缺如、由体动脉供应左下肺基底段患者的胸部螺旋CT表现。结果4例中2例病变累及左肺下叶各基底段,2例病变累及部分基底段,相应肺段肺动脉缺如,病肺密度呈磨玻璃样增高,支气管树连接正常,4例均见有1支异常血管约在第8胸椎水平起自降主动脉的左前外侧或左外侧,对应基底段肺静脉扩张,回流正常,与异常供血动脉间无直接交通。结论该病在增强螺旋CT图像中有特异性表现,作者认为命名为局限性肺动脉缺如比较合适,更能反映本病特点。

Objective To investigate the characteristic findings of an anomalous systemic arterial supply to the lung without the pulmonary artery on spiral CT and discuss its nomenclature.Methods Four cases of anomalous systemic arterial supply to the left basal segment of the lung without the pulmonary artery were retrospectively reviewed with analysis of the characteristic CT findings.Results On spiral CT scans,the involved left lower lung including the entire left basal segments（n=2）,the lateral and posterior basal segment（n=1）,and the anterior,medial,and posterior basal segment（n=1） had mild volume loss and areas of ground-glass opacity but with normal bronchial trees.The absence of the entire or part of the basal segments of the normal left lower lobar pulmonary artery,anomalous systemic artery originating from the abdominal aorta,diffuse dilatation of the systemic arterial branches distributed in the basal segments of the left lower lobe,and left lower pulmonary venous drainage into left atrium were found in all these patients.Conclusion This anomaly presents with characteristic findings on chest spiral CT,for which the nomenclature of local absent pulmonary artery better shows the characteristics of the disease.