选择性肺动脉造影及CTA诊断肺动脉假性动脉瘤

Selective Pulmonary Angiography and CT Angiography Pulmonary Artery Pseudoaneurysms

目的提高对肺动脉源性咯血的认识。方法回顾性分析5例经支气管动脉栓塞不能控制的大咯血患者的临床、肺动脉造影及CTA资料。结果 5例肺动脉源性咯血患者CTA均显示肺动脉假性动脉瘤,而肺动脉造影只显示其中的3例,另2例仅表现为病变肺段的肺动脉低灌注。结论单纯肺动脉造影可能漏诊肺动脉假性动脉瘤,CTA对此病具有更强的诊断能力,并对指导进一步的超选择性肺动脉造影及血管内栓塞治疗具有重要的临床价值。

Objective To improve the identification of hemoptysis of pulmonary arterial origin.Methods Selective pulmonary angiography,CTA and clincal data in 5 cases were analyzed retrospectively,and all these 5 patients were not controlled hemoptysis by bronchial arteries embolization.Results Hemoptysis of pulmonary arterial origin in 5 cases,namely pulmonary artery pseudoaneurysms,were diagnosed by CTA,of which only 3 cases were diagnosed by selective pulmonary angiography and other 2 cases manifested hypoperfusion of the diseased segment of the lung without contrast agent filling of the pseudoaneurysm.Conclusion Pulmonary angiography alone may fail to demonstrate pulmonary artery pseudoaneurysms.CTA has a stronger ability to diagnose pseudoaneurysms and play an important role in directing superselective pulmonary angiography and endovascular management.