支气管Dieulafoy病的支气管动脉CT造影特点  

The computed tomography angiography features of Dieulafoy disease of the bronchus

作　　者：潘峰[1] 王芳[2] 刘卓[1] 袁飞[1] 孙昆昆[3] 高占成[2] 孙烨[1] Pan Feng;Wang Fang;Liu Zhuo;Yuan Fei;Sun Kunkun;Gao Zhancheng;Sun Ye(Department of Radiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院放射科,100044 [2]北京大学人民医院呼吸与危重症医学科,100044 [3]北京大学人民医院病理科,100044

出　　处：《中华结核和呼吸杂志》2018年第12期949-953,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的观察支气管Dieulafoy病的支气管动脉CT造影(CTA)特点。方法回顾分析我院2010年7月4日至2016年6月20日确诊的6例支气管Dieulafoy病的临床、影像及病理资料,总结病变支气管动脉的CTA特点。结果6例中,男5例,女1例,年龄36~76岁,平均(55±15)岁。3例有吸烟史,1例有肺结核病史,1例有急性粒细胞白血病史。临床表现为不明原因大咯血、发热及肺部感染。3例行支气管动脉CTA检查,所见病变血管起源正常,走行明显迂曲扩张,管腔直径持续>2mm,远端未逐渐变细而呈突然截断表现,部分区域可见迂曲的血管突向支气管管腔且呈结节样改变。对2例支气管结节行支气管镜活检,均发生大出血,1例死亡,1例抢救成功。结论支气管Dieulafoy病的支气管动脉CTA特点是病变血管走行迂曲,管腔持续扩张,部分病变血管突向支气管管腔并呈结节样改变,可用于诊断支气管Dieulafoy病;对大咯血的患者不能盲目行支气管活检,尤其是支气管镜下见到内膜突起的光滑小结节时,应警惕Dieulafoy病的可能,应行支气管超声内镜或支气管动脉CTA检查。Objectives To summarize the computed tomography angiography(CTA)features of Dieulafoy disease of the bronchus.Methods The clinical,imaging and pathological data of Dieulafoy disease of the bronchus diagnosed in our hospital from July 4,2010to June 20,2016 were retrospectively analyzed,and the CTA imaging features of the abnormal bronchial arteries were summarized.Results There were 6cases of bronchial Dieulafoy disease,5 males and 1female,with an average age of(55±15) years.Three cases had smoking history,and 2cases had underlying diseases such as tuberculosis and acute myeloid leukemia.The common manifestations were hemoptysis,fever and pneumonia.Three patients got CTA examination,and bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated, with the vascular diameter lager than 2mm,no gradual narrowing but sudden truncation.Some circuitous vessels went into bronchial lumen as nodules.The bronchoscopy biopsy of 2 cases of bronchial nodules led to severe hemorrhage,with one death and one survival by successful management.Conclusions Bronchial arteries of Dieulafoy disease of the bronchus were circuitous and dilated,and some circuitous vessels went into bronchial lumen as nodules,this demonstration can be used to diagnose Dieulafoy disease of the bronchus.For patients with hemoptysis,bronchial biopsy should only be performed after CTA examination if this disease is suspected.

关 键 词：Diulafoy病 支气管 血管造影术 

分 类 号：R562.2[医药卫生—呼吸系统]