MSCT诊断先天性肺动脉吊带

Multi-slice spiral CT in diagnosis of congenital pulmonary artery sling

目的探讨先天性肺动脉吊带(PAS)的MSCT诊断、分型及PAS与气管和支气管树的关系。方法回顾性分析11例PAS的MSCT平扫及增强图像,根据PAS绕行气管所在胸椎平面将其分为Ⅰ、Ⅱ型。结果 11例PAS增强MSCT均表现为左肺动脉起源于右肺动脉,自右向左从气管后方、食管前方绕行至左侧肺门;其中ⅠA型1例,ⅡA型2例,ⅡB型8例,未见ⅠB型。1例ⅠA型PAS气管隆突位于T3平面,PAS从隆突后上方绕行至左侧肺门。10例Ⅱ型PAS假隆突位于T4-6平面,PAS从假隆突后上方绕行至左侧肺门。11例PAS均伴不同程度的气管、支气管狭窄,10例Ⅱ型PAS均伴支气管桥畸形。结论 MSCT平扫及重组图像可同时观察气管、支气管树及肺部病变;增强MSCT能够确诊PAS并显示其与气管、支气管树的关系。

Objective To observe the values of MSCT in diagnosis and classification of congenital pulmonary artery sling （PAS） and its relationship with the tracheobronchial tree. Methods Plain and contrast enhanced CT findings were retro- spectively analyzed in 11 children with PAS. According to the location of trachea carina PAS passed by, it was divided into type Ⅰnd type ⅡPAS. Results In all 11 children, enhanced MSCT imaging showed the left pulmonary artery originated from right pulmonary artery and bypass to the left hilar from right to left, behind the trachea and in front of the esophagus. PAS in 1 child was typeⅠA, in 2 children were type Ⅱ A, 8 children were type II B, while no type ⅠB PAS was detec- ted. In 1 typeⅡA PAS, the trachea carina located at T3 and PAS bypassed to the left hilar from back top of the carina. In 10 type 11 PAS, the pseudocarina located at T4-6 and PAS bypassed to the left hilar from back top of the pseudocarina. All 11 children had varying degrees of tracheobroncbial stenosis, 10 type 11 PAS were associated with bridging bronchus. Con- clusion MSCT plain scan and reconstructive image can be used to observe abnormalities of tracheobronchial tree and lung, and contrast enhanced CT scan can be used to make definite diagnosis of PAS and display its relationship with the tracheo- bronchial tree.