肺动脉闭锁伴室间隔缺损的肺血管解剖类型探讨  

Classification of the pulmonary circulation in pulmonary atresia with ventricular septal defect

作　　者：吴琳[1] 盛锋[1] 刘芳[1] 徐素梅[1] 陆颖[1] 

机构地区：[1]复旦大学附属儿科医院心血管中心,上海200032

出　　处：《医学影像学杂志》2008年第1期17-20,共4页Journal of Medical Imaging

摘　　要：目的:分析肺动脉闭锁合并室间隔缺损的肺动脉解剖形态与肺循环血供来源,探讨其适宜的肺血管造影方法。方法:回顾研究了38例肺动脉闭锁合并室间隔缺损的心血管造影结果,重点分析了肺动脉的起源、分布与解剖形态。所有病例均常规予以右室或左室造影和降主动脉上部造影,其中11例行选择性动脉导管造影,6例行选择性侧支血管造影。结果:全部38例患者中,肺循环血供主要来自于由动脉导管24例(63%),大型体-肺侧支7例(18%),动脉导管与大型体-肺侧支共存3例(8%),细小侧支4例(11%);其中8例显示肺动脉总干,27例显示中心肺动脉及共汇(71%)。结论:合并室间隔缺损的肺动脉闭锁可发生在不同部位,肺动脉的血供来源及解剖形态复杂多样化,心血管造影仍是定义其解剖分型的重要手段。Objective：To clarify the morphology of pulmonary arterial supply of pulmonary atreisa with ventricle septal defect （PA/ VSD） and to set up effective approach of selective catheterization and angiography.Methods： The angiograms were retrospectively studied in 38 eases of PA/VSD, focusing on the details of the origin, distribution and morphology of pulmonary arteries. Both right or left ventricle angiography and upper descending aortography were routinely carried out in all the eases. Selective catheterization for PDA was achieved in 11 eases and for major aortopulmonary collateral arteries in 6 cases.Results：In the total of 38 cases, the pulmonary arterial supply came from the arterial duct （PDA） in 24 （63%）, the major systemlc-pulmonary collateral arteries （MAPCAs） in 7 （18%）, PDA coexisting with MAPCAs in 3 （8 % ）, and the acquired collateral arteries in 4 （ 11% ）. The pulmonary trunks were identified in 8 eases and central pulmonary arteries were present and confluent in 27 cases （71%）. Conelusion：Variations are to be found in the site of pulmonary atresia and the morphology of the pulmonary arterial supply in congenital anomaly of PA/VSD. Selective catheterization and angiography is still the best way to classify the features of pulmonary perfusion.

关 键 词：心脏缺损 先天性 肺动脉闭锁 室间隔缺损 心血管造影术 

分 类 号：R543.2[医药卫生—心血管疾病] R814.43[医药卫生—内科学]