儿童交通性支气管肺前肠畸形的影像学诊断  

Imaging Diagnosis of Communicating Bronchopulmonary Foregut Malformation in Children

作　　者：张广风 董春华[1] 赵建设[1] ZHANG Guangfeng;DONG Chunhua;ZHAO Jianshe(Medical Imaging Department,Children’s Hospital Affiliated to Shandong University(Jinan Children’s Hospital),Jinan 250022,Shandong,P.R.China)

机构地区：[1]山东大学附属儿童医院(济南市儿童医院)医学影像科,山东济南250022

出　　处：《影像科学与光化学》2024年第4期359-363,共5页Imaging Science and Photochemistry

摘　　要：目的:旨在对儿童交通性支气管肺前肠畸形的影像学特点和临床表现进行总结。方法:回顾性分析于济南市儿童医院经手术后病理证实的3例儿童交通性支气管肺前肠畸形的影像学特征及临床信息,其中女2例,分别为月龄7月3天,吃奶费力伴口唇紫绀7月;出生13天,可疑肺发育不良,呛咳8天。男1例,年龄12岁2月,临床表现为间断胸痛10年,加重4月;3例术前均行X线、消化道造影、胸部CT平扫+增强、心脏CTA检查。结果:1例患者病灶在左肺,2例患者病灶在右肺。均与食管气管瘘合并,2例瘘均在食管下段,1例位于食管上段。其中伴肺发育不良2例,隔离肺1例,伴发心脏畸形2例。消化道造影能清楚地表明瘘的位置、形态和大小。CT检查显示该病特点及伴发畸形,心脏CTA检查能补充心内情况及血管发育异常等。结论:CBPFM包含肺组织、气管及脉管的异常,食管气管瘘也会合并在一起。胸部CT检查可直观地呈现肺组织、气管及脉管、前肠发育的异常情况以及各种伴发畸形等;心脏CTA检查能显示心内情况及血管发育异常;消化道造影可直接、清晰地显示隔离肺实质与胃肠道间异常管道的位置、形态及大小。将胸部CT、心脏CTA检查与消化道造影结合起来,是最好的检查手段。Objective:To summarize the imaging and clinical information of communicating bronchopulmonary foregut malformation(CBPFM)in children.Methods:Retrospective analysis of the imaging and clinical information of 3 CBPFM confirmed by postoperative pathology at Jinan Children’s Hospital.Among them,2 were female,one was 7 months and 3 days old,had difficulty feeding and had cyanotic lips for 7 months,and the other was 13 days old,suspected of pulmonary dysplasia,and coughed for 8 days.One male case,aged 12 years and 2 months,had clinical manifestations of intermittent chest pain for 10 years,which worsened for 4 months.All 3 cases underwent X-ray,gastrointestinal angiography,chest CT scan+enhanced,and cardiac CTA examination before surgery.Results:The lesion was in the left lung in 1 patient and in the right lung in 2 patients.All three cases were combined with esophagotracheal fistula,the fistulas in two cases were located in the lower esophagus,and one case was located in the upper esophagus.Among them,2 cases were accompanied by pulmonary dysplasia,1 case was accompanied by isolated lung,and 2 cases were accompanied by cardiac malformations.Digestive tract contrast clearly shows the location,shape and size of the fistula and CT examinations shows the characteristics of the disease and associated malformations.Cardiac CTA examination can supplement the condition of the heart and abnormal vascular development.Conclusion:CBPFM contains pulmonary tissue,trachea,and vascular abnormalities,and incorporates oesophageal trachea fistula.CT examinations provide a visual indication of lung tissue,trachea and vascular,anterointestinal development abnormalities and various associated malformations;cardiac CTA examination can display the condition of the heart and abnormal vascular development;digestive angiography provides a direct and clear indication of the location,morphology and size of the isolated lung substance and the abnormal pipe between the gastrointestinal tract.The combination of chest CT examination,cardiac CTA exa

关 键 词：支气管肺前肠畸形 胃肠道 影像诊断 CT检查 心脏CTA检查 

分 类 号：R445[医药卫生—影像医学与核医学]