胸部增强CT结合支气管内超声诊断无症状支气管Dieulafoy病一例  

A Case Report of Thoracic Enhanced Chest CT Combined with Endobronchial Ultrasound for the Diagnosis of Asymptomatic Bronchial Dieulafoy's Disease

作　　者：赵静 林宜亭 李运奎 张晓彤 赵媛媛 陈勇 陈珂琪 王孟昭[1] ZHAO Jing;LIN Yiting;LI Yunkui;ZHANG Xiaotong;ZHAO Yuanyuan;CHEN Yong;CHEN Keqi;WANG Mengzhao(Department of Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Pulmonary and Critical Care Medicine,Xiamen Haicang Hospital,Xiamen,Fujian 361026,China;Department of Pulmonary and Critical Care Medicine,First People's Hospital of Jingzhou,Jingzhou,Hubei 434000,China)

机构地区：[1]中国医学科学院北京协和医院呼吸与危重症医学科,北京100730 [2]厦门市海沧医院呼吸与危重症医学科,福建厦门361026 [3]荆州市第一人民医院呼吸与危重症医学科,湖北荆州434000

出　　处：《协和医学杂志》2023年第3期629-632,共4页Medical Journal of Peking Union Medical College Hospital

摘　　要：本文报道1例采用胸部增强CT结合支气管内超声(endobronchial ultrasound,EBUS)诊断的罕见无症状支气管Dieulafoy病患者,胸部增强CT可见左主支气管内结节样新生物,动脉期部分强化,支气管镜检查示左主支气管远端结节样黏膜隆起,表面光滑,可见细小血管,未见搏动,未行活检,行EBUS探查病灶支气管黏膜下血流情况,可见明显彩色血流信号。根据上述表现考虑诊断为支气管Dieulafoy病。对于未发生咯血的患者,如支气管镜检查有主气道结节样新生物,可采用胸部增强CT结合EBUS明确诊断,避免盲目活检而导致致死性大出血,该方法无创、安全且有效易行,值得临床推广应用。We reported a rare case of asymptomatic bronchial Dieulafoy's disease diagnosed by enhanced chest CT combined with endobronchial ultrasound(EBUS).The enhanced chest CT showed nodular neoplasm in the left main bronchus and partial enhancement in arterial phase.Bronchoscopy showed nodular mucosal protrusion lesion at the distal end of the left main bronchus,and the protrusion lesion had smooth surface and no pulsation,with some microvessels on it,and obvious submocasal blood flow signals were seen by endobronchial ultrasound.The diagnosis of bronchial Dieulafoy disease was considered based on the above findings and biopsy was not performed.In patients without haemoptysis,if there are nodular neoplasms in the main airway on bronchoscopy,enhanced chest CT combined with EBUS can be used to diagnose bronchial Dieulafoy's disease and avoid fatal haemorrhage due to conventional biopsy.The method is non⁃invasive,safe and effective,and worthy of clinical application.

关 键 词：支气管Dieulafoy病 支气管内超声 胸部增强CT 咯血 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.4[医药卫生—诊断学]