儿童先天性血管环41例多排螺旋CT诊断的回顾性分析

Diagnosis and analysis of 41 children diagnosed with congenital vascular ring MSCT

目的对我院近3年多排螺旋CT(MSCT)确诊的41例先天性血管环进行回顾性分析,评价多排螺旋CT(MSCT)对这一罕见病的检出率及应用价值。方法回顾性分析我院2016年4月至2019年6月经MSCT检查确诊的41例先天性血管环患儿的影像学资料,进行统计描述性分析。结果41例患儿中完全性血管环占17.1%(7/41),其中双主动脉弓(DAA)占85.7%(6/7),左弓迷走右锁骨下伴右侧动脉导管未闭(PDA)占14.3%(1/7);不完全性血管环占82.9%(34/41),其中右弓右降迷走左锁骨下占41.2%(14/34),伴右室双出口占2.9%(1/34),肺动脉吊带(PAS)占29.4%(10/34),迷走右侧锁骨下伴主动脉缩窄占5.9%(2/34),右位主动脉弓并主动脉离断伴PDA占5.9%(2/34),迷走右侧锁骨下伴永存左上腔占2.9%(1/34),伴左右颈总动脉(CCA)起始部共干占2.9%(1/34),伴迷走右侧椎动脉占2.9%(1/34),无名动脉压迫气道占5.9%(2/34)。41例患儿中合并心内畸形70.7%(29/41)。2.4%(1/41)合并多指畸形。结论MSCT进行儿童心脏大血管增强扫描可以很好显示血管环的组成及空间关系,为临床提供可靠的影像依据。

Objective To analyze 41 cases of congenital vascular rings diagnosed in recent three years in our hospital,and to evaluate detectable rate of MSCT to this rare disease and meaning of MSCT in diagnosis of congenital vascular rings.Methods Forty one cases were enrolled,who were diagnosed with congenital vascular rings between April 2016 and June 2019.All case reports and images documents were reviewed and analyzed.Results percentage of comelete congenital vascular rings was 17.1%(7/34).Among them,85.7%(6/7)cases belonged to double aortic arch and 14.3%(1/7)belonged to left aberrant right subclavianartery with patent ductus arteriosus on the right side.Percentage of incomplete congenital vascular rings was 82.9%(34/41).The distribution was 41.2%(14/34)on right aortic arch and aberrant right subclavianartery and 2.9%(1/34)with double exits of right ventricle,29.4%(10/34)on pulmonary artery sling,5.9%(2/34)on aberrant right subclavian artery with aortic stenosis,5.9%(2/34)on aortic arch with interruption and patent ductus arteriosus,The osteido right collarbone artery with permanent survival of the upper left cavity accounted for 2.9%(1/34),with the left and right main artery starting part of 2.9%(1/34),the lost right vertebral artery accounted for 2.9%(1/34),the nameless artery compression trachea accounted for 5.9%(2/34).There were 70.7%(29/41)cases combined with Intracardiae malformation and 2.4%(1/41)with polydactylism.Conclusion The advantage of MSCT inimaging diagnosis of heart and great vessels was clearly showing branch of vessels and special correlation.That might provide valuable imaging diagnosis for clinic practice.