儿童叶外型肺隔离症合并扭转的临床特点及影像学表现  

Clinical and imaging features of extralobar pulmonary sequestration with torsion in children

作　　者：白慧萍[1] 郝跃文 魏思文 张鹏 张爱辉[2] BAI Huiping;HAO Yuewen;WEI Siwen;ZHANG Peng;ZHANG Aihui(Department of Radiology,Xi'an Children's Hospital,Xi'an 710003,China;Department of Chest Surgery,Xi'an Children's Hospital,Xi'an 710003,China)

机构地区：[1]西安市儿童医院放射科,陕西西安710003 [2]西安市儿童医院胸外科,陕西西安710003

出　　处：《实用放射学杂志》2024年第1期100-102,共3页Journal of Practical Radiology

摘　　要：目的探讨叶外型肺隔离症(ELS)合并扭转的临床特点及影像学表现。方法回顾性分析4例ELS合并扭转患儿的临床资料、影像资料、手术记录及病理结果。结果4例患儿均以腹痛就诊,CT扫描均于下叶后内侧发现软组织包块,右侧2例呈长梭形,左侧2例呈类圆形,皆伴有胸腔积液及邻近肺叶通气不良。增强扫描1例未见明显强化,1例实质轻度强化,2例边缘线样强化。4例包块均未见明确供血动脉,3例周围肋间后静脉扩张。术中均显示ELS合并扭转,滋养动脉来自胸主动脉。病理结果均显示ELS并出血、坏死,1例合并先天性肺气道畸形2型。结论ELS合并扭转多以腹痛为首发症状,影像学表现为邻近下叶软组织包块合并患侧胸腔积液,增强扫描包块无明显强化、轻度强化或边缘线样强化,供血动脉多不显示,肋间后静脉扩张多见。Objective To investigate the clinical and imaging features of extralobar pulmonary sequestration(ELS)with torsion.Methods The clinical and imaging data,surgical records and pathological results of four ELS children with torsion were analyzed retrospectively.Results All four children presented with abdominal pain,and all CT scans showed soft tissue masses on the medial side of the lower lobe,and there were 2 masses with long fusculine-shaped in the right pleural cavity,2 round masses in the left pleural cavity,all of which were accompanied by pleural effusion and poor ventilation of adjacent lung lobes.There were 1 case without enhancement,1 case with mild enhancement,and 2 cases with simple marginal linear enhancement.There were no patients with definitive supplying artery and 3 cases with peripheral post-intercostal dilated veins.Intraoperative ELS combined with torsion was shown,and the nutrient artery were derived from the thoracic aorta.All ELS showed bleeding and necrosis according to the pathological results,and 1 case was complicated with congenital pulmonary airway malformation(type 2).Conclusion ELS combined with torsion is mostly abdominal pain as the first symptom,and there are soft tissue mass adjacent to the lower lobe with pleural effusion on the affected side as the imaging features with no,mild or marginal linear enhancement,with no supplying artery,and with intracostal posterior venous expansion.

关 键 词：儿童 叶外型 肺隔离症 扭转 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学] R445.2[医药卫生—临床医学]