双源CT冠状动脉成像意外检出冠状动脉-肺动脉瘘的价值分析  

Value Analysis of Accidental Detection Of Coronary Artery-pulmonary Fistula by Dual-source CT Coronary Imaging

作　　者：陈昂 屈晓艳 魏耀宁 刘锦 安攀 CHEN Ang;QU Xiao-yan;WEI Yao-ning;LIU Jin;AN Pan(Department of radiology,the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,Shaanxi Province,China)

机构地区：[1]空军军医大学第二附属医院放射科,陕西西安710038

出　　处：《中国CT和MRI杂志》2025年第2期104-106,116,共4页Chinese Journal of CT and MRI

摘　　要：目的基于冠状动脉CT血管成像(CCTA)资料,探讨冠状动脉-肺动脉瘘(CPAFs)的意外检出率,总结其临床及影像学特征,以提高临床认知。方法回顾性分析我院2020年1月-2023年10月41例CPAFs患者的临床资料,所有患者均行CCTA,结合原始图像及多种后处理图像方法,分析其影像特征。结果24051例CCTA检查中,共发现CPAFs 41例,包括左冠状动脉-肺动脉瘘16例(39.02%),右冠状动脉-肺动脉瘘2例(4.88%),双侧冠状动脉-肺动脉瘘23例(56.10%);41例CPAFs患者共68支瘘血管,前降支(LAD)-肺动脉瘘35支(51.47%);可测量的瘘口共45个,其中单发瘘口37例、多发瘘口4例,瘘口呈“喷射征”23例、“浓染征”16例、“等密度征”2例;合并瘘血管动脉瘤15例。结论CPAFs并不罕见,检出率0.17%,其中LAD-肺动脉瘘最常见,部分患者可出现冠心病的临床症状,CCTA作为一种有用的、无创的检测CPAFs的方法,在CCTA时,每一位影像科医师应常规评价患者有无CPAFs。Objective To investigate the accidental detection rate of coronary to pulmonary artery fistula(CPAFs)based on coronary CT angiography(CCTA)data,summarize its clinical and imaging characteristics,so as to improve clinical cognition.Methods The clinical data of 41 patients with CPAFs in our hospital from January 2020 to October 2023 were retrospectively analyzed.All patients underwent CCTA,and their image characteristics were analyzed by combining original images and multiple post-processing image methods.Results Among 24051 cases of CCTA,41 cases of CPAFs were found,including 16 cases of left coronary artery-pulmonary artery fistula(39.02%),2 cases of right coronary artery-pulmonary artery fistula(4.88%),23 cases of bilateral coronary artery-pulmonary artery fistula(56.10%).There were 68 fistula vessels in 41 CPAFs patients,35 of which were anterior descending branch(LAD)and pulmonary artery,accounting for 51.47%.There were 45 measurable fistulas,including single fistulas in 37 cases,multiple fistulas in 4 cases,“ejection sign”in 23 cases,“hyperchromatic sign”in 16 cases and“iso-density sign”in 2 cases.15 cases complicated with fistula vascular aneurysm.Conclusion CPAFs is not rare,with a detection rate of 0.17%,among which lad-pulmonary artery fistula is the most common,and some patients may have clinical symptoms of coronary heart disease.CCTA is a useful and non-invasive method to detect CPAFs.During CCTA,every radiologist should routinely evaluate whether the patient has CPAFs.

关 键 词：冠状动脉病变 肺动脉 动脉动脉瘘 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R445[医药卫生—内科学]