应用CT诊断成人部分型肺静脉异位引流  

Application of CT in the diagnosis of partial anomalous pulmonary venous connection

作　　者：李清华[1] 

机构地区：[1]河南省胸科医院放射科,郑州450008

出　　处：《中国实用医刊》2008年第17期13-15,共3页Chinese Journal of Practical Medicine

摘　　要：目的系统阐述成人部分型肺静脉异位引流CT检查的影像学特点及其临床意义。方法回顾性分析29例成人部分型肺静脉异位引流的CT检查资料。其中女性19例，男性10例。平均年龄41岁（19～55）。胸片（25例）中观察纵隔轮廓的异常、心脏的大小及肺血管情况。胸部CT中阅读异位引流静脉的位置、大小及所流入的心腔；正常肺静脉位置存在肺静脉与否；心脏大小及形状；肺血管情况。结果79％（23／29）的病人有一异常的左上肺叶静脉连接到永存的左垂直静脉，其中5％（1／23）病人有一左上肺叶静脉在正常位置。17％（5／29）的病人有一异常的右上肺叶静脉引流入上腔静脉，其中60％（3／5）的病人1支右上肺叶静脉也在正常位置。1例（3％，1／29）病人有一异常的右下肺叶静脉引流入肝脏上方的下腔静脉。胸片结果：64％（15／25）的病人左侧纵隔轮廓异常，8％（2／25）的病人右侧纵隔轮廓异常。24％的病人（6／25）心影增大。CT结果：48％的病人（14／29）心影增大，31％（9／29）的病人右心房扩大，31％（9／29）的病人右心室扩大，14％（4／29）的病人肺动脉增宽。结论，成人异位引流肺静脉常源于左上肺叶，鲜有女性病人合并房间隔缺损。Objective To systematically describe the imaging features and clinical correlates of partial anomalous pulmonary venous connection diagnosed on computed tomography （CT） in adults. Methods Twenty -nine adults with partial anomalous pulmonary venous connection on CT were retrospectively identified. There were 19 women and 10 men, with a mean age of 41 （range： 19 -55 ） years. Chest radiographs （25 of 29 cases） were reviewed for mediastinal contour abnormalities, heart size, and pulmonary vascular pattern. Chest CT scans were reviewed for location, size, and drainage site of the anomalous vein; presence or absence of a pulmonary vein in the normal location; cardiac size and configuration; and pulmonary vasculature. Results Seventy - nine percent （ 23 of 29 patients） had an anomalous left upper lobe vein connecting to a persistent left vertical vein, only 5% （1 of 23 patients） of whom had a left upper lobe vein in the normal location. Seventeen percent （5 of 29 patients） had an anomalous fight upper lobe vein draining into the superior vena cava, 60% （3 of 5 patients） of whom also had a fight upper lobe pulmonary vein in the normal location. One patient （3%） had an anomalous right lower lobe vein draining into the suprahepatio inferior vena cava. Chest radiographic findings were abnormal left mediastinal contour in 64% （15 of 25 patients）, abnormal right mediastinal contour in 8% （2 of 25 patients ）, and cardiomegaly in 24% （ 6 of 25 patients）. Computed tomography findings were cardiomegaly in 48% （ 14 of 29 patients）, right atrial enlargement in 34% （9 of 29 patients）, right ventricular enlargement in 31% （9 of 29 patients）, and pulmonary artery enlargement in 14% （ of 29 patients）. Conclusion The anomalous vein in adults are most commonly from the left upper lobe, in women, and infrequently associate with atrial septal defects.

关 键 词：CT 诊断 成人 部分型肺静脉异位引流 

分 类 号：R816[医药卫生—放射医学] R54[医药卫生—临床医学]