迷走右锁骨下动脉 CT 表现及临床意义  

CT appearances and clinical significance of aberrant subclavian arteries

作　　者：周丽[1,2] 李春平[1] 杨帆[1] 陈天武[1] 杨广夫[2] 

机构地区：[1]川北医学院附属医院CT室,四川南充637000 [2]西安交通大学附属高新医院影像中心

出　　处：《实用放射学杂志》2015年第2期208-211,共4页Journal of Practical Radiology

摘　　要：目的：回顾分析迷走右锁骨下动脉（ARSA）的CT表现及ARSA的临床意义。方法经多层螺旋CT （MSCT）增强扫描确诊的 ARSA 45例,收集相应的临床资料。记录 ARSA 起始位置,走行,测定 ARSA 起始部位直径及直径与主动脉弓横径比值（ratio,R）。结果45例病例中39例（86.7%）为 CT 检查过程中偶然发现,6例（13.3%）因有吞咽困难,胸痛、气喘等症状前来就诊。45例 ARSA 均横跨食管后方,其中35例（77.7%）起始位置位于 T4椎体层面,10例（22.3%）位于 T3椎体层面。45例 ARSA起始部位平均直径为13.5 mm,其中4例 ARSA 起始部位直径与主动脉弓横径比值 R≥1,定义为 Kommerell 憩室,占总人数8.9%。结论认识 ARSA 具有重要的临床意义,MSCT 增强扫描是诊断 ARSA 的一种很有价值的影像方法。Objective To analyze retrospectively CT appearances and clinical significance of aberrant subclavian arteries （ARSA）. Methods 45 cases with ARSA confirmed by multi-slices multidetector computed tomographic （MSCT）contrast-enhanced imaging on chest were included in this study.The clinical features were analyzed furthermore.The origin location and direction of ARSA were recorded.The proximate diameter of ARSA and ratio （R）of the diameter to short axis of aortic arch were measured.Results 39 ca-ses （86.7%）of ARSA were diagnosed incidentally,but 6 cases （13.3%）had symptoms of either dysphasia,chest pain or asthma.All 45 cases of ARSA crossed the behind the esophagus,in which the origin location of ARSA in 35 cases （77.7%）located in the fourth thoracic vertebrae aspect and the third thoracic vertebrae aspect in 10 cases （22.3%）.In the 45 cases,the mean proximate diameter of ARSA was 13.5 mm.When the R of the proximate diameter of ARSA to short axis of aortic arch was measured,4 cases （8.9%） with R≥1 were defined as Kommerell’s diverticulum.Conclusion Recognition of ARSA has important clinical significance,and MSCT are valuable in diagnosing ARSA.

关 键 词：迷走右锁骨下动脉 计算机体层成像 

分 类 号：R543.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]