先天性主动脉弓褶叠畸形

Congenital kinking of the aorta

目的 讨论先天性主动脉弓褶叠畸形的病理改变与影像学表现及诊断要点。方法 回顾分析9例(男5例,女4例,年龄15—52岁,平均33.8岁)经造影证实的主动脉弓褶叠的平片、DSA及2例MRI、2例CT增强扫描的影像。结果 9例胸片显示左上纵隔“块影”,其中3例主动脉弓升高,2例侧位胸片示主动脉弓降部呈“3”字形,升主动脉DSA在左前斜位显示4例主动脉弓降部呈“3”字形扭曲,5例褶叠血管呈团块状。2例CT增强扫描于主动脉弓上层面见扩张的血管团。2例MRI左前斜位成像示1例主动脉弓呈“3”字形,1例呈团块形。结论 主动脉弓褶叠在各种影像检查方法中有其不同表现,以DSA、MRI表现具特征性。主动脉弓降部管腔不窄,但迂曲、升高呈“3”字形改变为其典型表现,是确诊的主要依据。

Purpose To study the relationship between pathology and imaging features of congenital kinking of the aortic arch. Methods 9 patients(5 males,4 females, age ranged from 15 to 52, mean age 33.8) suffering from the congenital kinking of the aortic arch proven by aortography were studied. The imaging features of the chest radiography, DSA, CT(2 contrast enhanced )and MRI(2 cases) were analysed. Results In all 9 cases, left superior mediastinal 'mass' appeared on chest plain film , while 3 cases had abnormal high aortic arch and 2 cases had elongation of aortic arch on lateral plain film .4 cases displayed '3' sign of aortic arch on aortography by DSA, 5 cases showed masslike elongation of aortic arch, and 2 cases displayed vesselsmass above aortic arch slice of CT contrast enhancement image. One case showed '3' sign and another masslike shadow on MRI. Conclusion There were various findings of kinking of the aortic arch on imaging examination. Typical features including '3' sign and elongation of the aortic arch appeared on DSA and MRI, from which the diagnosis can be made.