右室阻塞性异常肌束的放射诊断

RADIOLOGIC STUDY OF OBSTRUCTING ANOMALOUS MUSCLE BUNDLE OF THE RIGHT VENTRICLE

本文报告经心血管造影和(或)手术证实的右室阻塞性异常肌束27例,对本病的造影和X线平片表现进行了分析,并结合临床及手术所见重点讨论了心血管造影的诊断和鉴别诊断问题,以及平片所见与临床的联系。

Obstructing muscle bundle of the right ventricle is an uncommon congenital malformation. The radiologic findings of both plain films and angiocardiograms in 27 cases with this malformation were analysed, and the radiologic diagnosis, correlated with clinical features, was discussed. Of the 27 cases, 24 cases were associated with ventricular septal defect, 4 with pulmonar y valvular stenosis, and one with subaortic stenosis.According to the position of the obstructing muscle bundle, the entity could be divided into three types: high type, low type and mixed type in 16, 2, and 9 cases respectively. The main angiocardiographic features were as follows: (1) mass-like or band-like filling defect at the ostium infundibulum and/or the midsinus portion of the right ventricle,(2) n arrowed orifice caused by the obstructing muscle bundle, and (3) welldeveloped infundibulum and main pulmonary artery.In the low and mixed type, the obstructing muscle bundle had certain characteristic features, precise diagnosis could be made by angiocardiography. Careful observation of the position of the obstructing muscle bundle, the development of the infundibulum and the main pulmonary artery, the size of the associated ventricular septal defects and the degree of aortic overriding, may aid in the differentiation of high type obstructing muscle bundle from tetralogy of Fallot.