肺隔离症的影像诊断和介入治疗

Imaging Diagnosis and Interventional Therapy of Pulmonary Sequestration

目的 探讨肺隔离症的影像学表现及介入治疗的应用价值。资料与方法 对 5例肺隔离症患者的X线平片、CT、MRI表现进行分析 ,并对隔离的肺组织的供血动脉进行栓塞。结果 X线平片主要表现为囊状或团状高密度影及支气管扩张样改变 ,CT、MRI可发现部分异常供血动脉 ,血管造影均能发现供血动脉 ,经异常供血动脉采用不锈钢圈栓塞后临床症状逐渐减轻、消失 ,随访 6个月～ 1年 ,症状未再复发。结论 在影像诊断方面 ,X线平片难以确诊 ,CT、MRI可部分确诊 ,而DSA检查是肺隔离症诊断的金标准。经异常供血动脉栓塞治疗肺隔离症安全 ,患者痛苦小 ,并发症少 。

Objective To discuss the imaging manifestations of pulmonary sequestration and its interventional management.Materials and Methods Imaging findings, including plain radiograph, CT and MRI, in 5 patients with pulmonary sequestration were analyzed. Interventional embolization of lesion's feeding artery as the treatment was carried out.Results On plain film, the lesion mainly presented as a cystic or lump-like high density shadow, or a shadow similar to bronchiectasis. CT and MRI could reveal the abnormal feeding arteries in some cases. Angiography could demonstrate the feeding artery in all cases. After interventional embolization of the feeding artery with steel coils, the clinical symptoms gradually abated and finally disappeared. No recurrence was seen during a follow-up period of 6～12 months.Conclusion It is difficult for plain film only to make a correct diagnosis of pulmonary sequestration. CT and MRI can confirm the diagnosis in some patients. DSA is the gold standard in identifying the lesion. Interventional embolization of the abnormal feeding artery is an effective and safe technique for the treatment of the disease with less complication.