大动脉炎肺动脉受累的常规超声与超声造影表现

Assessment of pulmonary artery involvement in Takayasu′s arteritis by conventional ultrsound and contrast-enhanced ultrasound

目的探讨大动脉炎肺动脉受累的常规超声及超声造影特点及在疾病诊断中的价值。方法回顾分析5例大动脉炎肺动脉受累患者的超声心动图、外周血管超声及心脏和外周血管超声造影的表现。结果 5例患者中主要的常规超声表现:三尖瓣反流(4/5)、肺动脉瓣反流(2/5)、肺动脉高压(3/5)、左或右肺动脉主干管腔细小(3/5)、左或右肺动脉主干管壁增厚回声减低(3/5),肺动脉以外的外周动脉受累(5/5);超声造影表现:左或右肺动脉主干管腔呈低或无增强(4/4),外周动脉增厚管壁明显增强或少量增强(4/5),无增强(1/5)。结论大动脉炎肺动脉受累的超声表现有其特征性,肺动脉的常规超声和超声造影检查结合临床表现及外周动脉的病变情况将有助于明确诊断。

Objective To investigate the characteristics of pulmonary artery involvement in Takayasu′s arteritis by conventional ultrasound and contrast-enhanced ultrasound and its value in the diagnosis of the disease. Methods The ndings of echocardiography, peripheral vascular ultrasound, and contrast enhanced ultrasound of the heart and peripheral vessels were reviewed and analyzed in 5 patients with pulmonary artery involvement in Takayasu′s arteritis. Results The main features of conventional ultrasound in 5 patients were as follows: tricuspid regurgitation (4/5), pulmonary valvular regurgitation (2/5), pulmonary arterial hypertension (3/5), the diameter of the left or right pulmonary artery was decreased (3/5), the wall of the left or right pulmonary artery was thickened and the echogenicities were decreased (3/5), the peripheral vessels outside the pulmonary artery were invaded (5/5). The main features of contrast-enhanced ultrasound in 5 patients were as follows: the diameter of the left or right pulmonary arteries showed low or no enhancement (4/4), thickened vascular walls were markedly or slightly enhanced (4/5), thickened vascular walls were not enhanced (1/5). Conclusions The ultrasonic manifestations of pulmonary artery involvement in Takayasu′s arteritis have some characteristics. Conventional plus and contrast-enhanced ultrasound combined with clinical manifestations and peripheral vascular findings will be helpful in the diagnosis of pulmonary arteries involvement in Takayasu′s arteritis.