主动脉弓左侧先天性静脉异常的CT鉴别诊断  

Various anomalous veins left to aortic arch distinction based on CT findings

作　　者：陈起航[1] 潘纪戍[1] 杨明[1] 刘甫庚[1] 周诚[1] 

机构地区：[1]北京医院放射科,100730

出　　处：《中华放射学杂志》2001年第6期448-452,共5页Chinese Journal of Radiology

摘　　要：目的　分析 41例主动脉弓左侧先天性静脉变异的CT表现及鉴别诊断。方法　所有患者均有CT平扫 ,其中 36例行增强扫描 ,5例另做MR或超声检查确诊。 6例做最大信号强度投影和表面遮盖法三维重建。结果　永存左上腔静脉 2 4例 ,其中双上腔静脉 2 3例 ,永存左上腔静脉并右上腔静脉缺如 1例。异常左头臂静脉 11例 ,其中 6例合并主动脉弓畸形 ;左上叶的部分异常肺静脉引流 4例 ,其中 1例并双上腔静脉畸形 ;左头臂静脉与奇静脉异常连接 2例。它们的共同表现是在主动脉弓左侧可见圆形或类圆形结节影 ,但它们具有各自不同的血管行程 ,可加以区别。结论　熟悉这些少见的先天性异常有助于避免误诊 ,高质量的CT增强扫描对这些先天性异常的诊断及鉴别诊断有重要价值。Objective To review the CT appearance of various anomalous mediastinal veins left to aortic arch and provide guideline for differentiating between them. Methods All 41 patients (26 men, 15 women; mean age 50.6) underwent CT scan and no one associated with congenital heart disease. 36 of which had the injection of IV contrast material. Others had chest MRI or ultrasound examination. Three-dimension (3D) and MIP reconstruction of the major mediastinal vascular structures were performed in 6 patients. All the CT scans were reviewed in order to observe the CT findings in each anomaly. Results Of the all cases, 24 cases had persistent left superior vena cava, of them, 23 cases with duplication of SVC, and 1 case with absent right SVC. Eleven cases had anomalous left brachiocephalic vein, and 6 of 11 cases were associated with various anomalous aortic arches. Four patients had partial anomalous pulmonary venous drainage of the left upper lobe. Two cases had left brachiocephalic vein continuation of the azygos vein. There were different CT findings among various types of venous anomalies, especially their courses below the aortic arch. Conclusion Contrast enhancement CT scan was valuable in the diagnoses of these anomalous veins. Careful analysis of the CT scans allowed the radiologist to avoid making wrong diagnosis.

关 键 词：主动脉弓左侧先天性静脉异常 CT 鉴别诊断 

分 类 号：R816.2[医药卫生—放射医学]