肱-腋动脉体外临时阻断后行锁骨下动脉造影对判断咯血来源血管的价值  

Subclavicular angiography with brachial-axillary artery externally and temporally occluded in interventional treatment of hemoptysis

作　　者：伍筱梅[1] 梁荣光[1] 赖清[1] 钱元新[1] 陈志远[1] 李平[1] 

机构地区：[1]广州医学院第一附属医院广州呼吸疾病研究所放射科,510120

出　　处：《中华放射学杂志》2011年第7期670-673,共4页Chinese Journal of Radiology

基　　金：广东省科技计划项目（2010B031600144）

摘　　要：目的探讨肱-腋动脉体外临时阻断后行锁骨下动脉造影对显示肩颈-胸壁区咯血来源叭管的作用，评价其在咯血介入治疗中的应用价值。方法回顾103例咯10L病例的DSA资料，分析起源于肩颈-胸壁区的责任异位支气管动脉（EBA）和非支气管动脉性体动脉侧支（NBSA）的发生牢，以及通过肱-腋动脉体外临时阻断后行锁骨下动脉造影显示肩颈-胸壁区EBA和NBSA的检出率。结果本组DSA检出的372支病变血管中，正常起源的支气管动脉（BA）193支（51．9％）、EBA25支（6．7％）；NBSA154支（41．4％）。肩颈-胸壁区EBA＋NBSA80支，占病变血管总数的21．5％（80／372），EBA＋NBSA总数的44．7％（80／179）；其中胸廓内动脉来源45支，占肩颈-胸壁病变血管总数的56．3％（45／80）。肱-腋动脉体外临时阻断后行锁骨下动脉造影114支，首次造影满意显爪肩颈-胸壁责任血管112支，满意率98．2％。结论肩颈一胸壁区是EBA和NBSA的重要发源地。肱-腋动脉体外阻断后行锁骨下动脉造影利于该区域病变血管的显示，可作为咯血介入治疗病变血管探查的常规造影方法。Objective To evaluate subclavicular angiography with brachial-axillary artery externally and temporally occluded in depicting hemoptysis-related ectopic arteries originating from shoulder, neck and chest wall in the interventional treatment of hemoptysis. Methods A retrospective analysis of the medical records and angiograms of 103 patients who underwent transarterial proeedures tor hemoptysis was carried out. The arteries originating from the subclavicular arteries supplying the shoulder, the neck and the chest wall, ectopic bronchial arteries （EBA） as well as non bronchial systemic arteries （NBSA） , were depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. The nmnbcr and distribution of the responsible aberrant arteries were investigated. Results Of the hemoptysis-related arteries（ n = 372） depicted and embolized in the studies, 51.9% was normally-originated bronchial arteries （n = 193） ,6.7% was ectopic bronchial arteries （ n = 25 ） ,41.4% was NBSA（ n = 154）. Both anomalous and NBSA arising from subclavicular-axillary area （n = 80） were accounted for 21.5% （80/372） of all aberrant arteries, and 44. 7% （80/179） of all anomalous and NBSA （n =25 ± 154 = 179）. Of those arising from subclavicular-axillary arteries,56. 3% （45/80） were found to be originated from the internal thoracic artery （n = 45 ）,98.2% （112/114）of responsible internal thoracic arteries and their distal branches were well depicted by subelavicular angiography with braehial-axillary artery externally and temporally occluded. Conclusion Subclavieular-axillary artery is a very important vessel where EBA and NBSA originate. Subclavieular angiography with brachial-axillary artery externally and temporally oceluded could help to determine the abnormal arteries in the region quickly. The method should be taken as a routine procedure for interventional treatment of hemoptysis.

关 键 词：咯血 支气管动脉 锁骨下动脉 血管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学]