Vieussens环及相关病变640层CT血管成像诊断分析  

Diagnostic value of 640-slice CT angiography for Vieussens’arterial ring

作　　者：曲迎午 庞智英 张玉姣 杨飞[1] 朱月香[1] 崔书君[1] QU Ying-wu;PANG Zhi-ying;ZHANG Yu-jiao;YANG Fei;ZHU Yue-xiang;CUI Shu-jun(Department of Medical Imaging,The First Affiliated Hospital of Hebei North University,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院医学影像部,河北张家口075000

出　　处：《影像诊断与介入放射学》2022年第4期259-263,共5页Diagnostic Imaging & Interventional Radiology

基　　金：2021年度河北省卫健委医学科研课题(20210342)。

摘　　要：目的探讨640层CT血管成像对Vieussens环的诊断价值。方法回顾性分析曾行冠状动脉CT血管成像并具有Vieussens环的患者42例,收集其原始图像及临床资料,并对原始图像进行多种后处理技术,包括多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)及容积重组(VR)等,测量并记录肺动脉瘘口大小、左冠状动脉圆锥支开口大小、右冠状动脉圆锥支开口大小。结果42例Vieussens环,伴肺动脉瘘38例,大瘘口23例,小瘘口15例,其中肺动脉瘘口可见“喷射征”22例及“浓染征”20例,两组间差异有统计学意义(P<0.05);23例伴有冠心病;5例伴有心肌桥;13例伴有瘤样扩张或动脉瘤(P<0.05);临床表现胸痛26例(P<0.05),呼吸困难4例,杂音3例。肺动脉瘘口大小、左冠状动脉圆锥支开口大小、右冠状动脉圆锥支开口大小的平均值及95%置信区间分别为(2.7±1.6)mm、2.1~3.2 mm,(1.8±0.7)mm、1.6~2.1 mm,(2.0±0.7)mm、1.7~2.2 mm。结论640层MSCT血管成像能准确显示Vieussens环开口大小、走行、邻近解剖关系及伴随其他异常改变,并可为Vieussens环患者临床进一步评估与治疗提供一定依据。Objective To investigate the diagnostic value of 640-slice CT angiography(CTA)in Vieussens’arterial ring.Methods Coronary CTA of 42 patients with Vieussens’arterial ring was retrospectively analyzed.Various post-processing techniques were performed on the original CTA images including multiplanar reconstruction,curved planar reconstruction,maximum intensity projection,and virtual reconstruction.The size of the pulmonary artery fistula and the opening size of the left and right coronary conus branches were measured.Imaging signs and clinical manifestations were recorded.Results There were 42 Vieussens’rings accompanied by 23 large and 15 small pulmonary artery fistulas.In 48 pulmonary fistulas,there was significant difference(P<0.05)in the occurrence of jet sign(22)and thick stain sign(20).Twenty-three patients had coronary heart disease;5 had myocardial bridge;13 had tumor-like dilatation or aneurysm(P<0.05).Chest pain(26)was significantly more common clinical presentation(P<0.05)than dyspnea(4)and heart murmurs(3).The mean size of pulmonary artery fistula was(2.7±1.6)mm;left conus branch opening size was(1.8±0.7)mm and right conus branch opening size was(2.0±0.7)mm.Conclusion 640-slice CTA can accurately display Vieussens’ring opening size,route,adjacent anatomical relationship and other accompanying abnormalities and provide a basis for further management.

关 键 词：Vieussens环 肺动脉瘘 多层螺旋CT 后处理技术 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]