DSA上支气管动脉间侧支吻合及其临床意义初探

Anastomoses Between Bronchial Arteries on DSA and Its Clinical Implications: A Preliminary Report

目的 探讨DSA上支气管动脉间的侧支吻合及其临床意义。资料与方法 对 90例肺癌或咯血病例中的 4 8例的支气管动脉DSA图像进行分析 ,观察有无通过侧支吻合显示其他支气管动脉开口和走行 ;对另外 4 2例的造影片在介入操作中进行DSA动态回放 ,观察到其他支气管动脉开口后 ,即时根据开口部位行插管造影证实。结果 共行 12 3支支气管动脉造影 ,发现 15例中支气管动脉有吻合 (15 /90 ,16 .7% ) ,其中 14例表现为插管的支气管动脉附近或远处另一支支气管动脉间断显影和主动脉壁上类圆形染色 (支气管动脉开口 ) ;另 1例左侧支气管动脉造影显示起源于左锁骨下动脉的右畸形支气管动脉。DSA动态回放发现吻合的 8例中 ,根据显示的支气管动脉开口均插管造影证实。结论 支气管动脉间存在一定机率的吻合 ,重视这种吻合 ,有助于支气管动脉的寻找、多支血供的发现。

Objective To analyze the anastomoses between bronchial arteries (BAs) on DSA and its possible clinical implications. Materials and Methods Of the 90 cases with lung cancer or hemoptysis, hard copies (films) of BA DSA were reviewed in 48 cases to analyze if there is enhancement of the other BAs (the opening and the route) by collateral circulation. In the other 42 cases, the cine loops were reviewed immediately after angiography. If the orifice of other BA was visualized, catheterization negotiating the orifice was performed to confirm the existing of the collateral circulation.Results Totally 123 BA angioigraphies were analyzed. Anatomoses were observed in 15 cases (15/90, 16.7%), characterized by adjacent or distal intermittent enhancement of the anastomic BA and small circular stain on the wall of the aorta (opening) in 14 cases, while in the remaining one case, left BA DSA showed right BA abnormality originating from left subclavian artery. All the 8 anastomic BAs detected on cine loop were successfully demonstrated according to the opening displayed. Conclusion There is certain frequency of anastomosis between BAs. Notification of such anastomosis may be helpful for search of BA, multiple blood supply, and also helpful for repeated interventional therapy