论文部分内容阅读
目的总结先天性迷走左肺动脉(CALPA)的临床及影像学表现,加强对本病的认识。方法回顾性分析郑州市儿童医院证实的先天性迷走左肺动脉患儿5例,所选患儿均行X线平片检查,4例行彩色多普勒超声及CT血管造影(CTA)检查。结果本组患儿临床表现为咳嗽、气促、喉喘鸣及呼吸困难,体检三凹征阳性;X线平片表现为两肺血增多、心脏增大,两肺斑片状、片絮状密度增高影。超声心动图见主肺动脉扩张,左肺动脉起自右肺动脉,部分患儿合并其他心血管畸形。CTA血管成像显示两肺血增多、心影以左房及右房增大为主,主肺动脉扩张,左肺动脉自右肺动脉发出,沿左主支气管后壁向后外侧延伸。结论气道不全性梗阻引起的通气障碍为本病最突出的临床表现,心脏CTA可以同时观察到患者肺部及血管情况,结合X线平片及超声心动图检查可为临床诊治本病提供可靠的影像学依据。
Objective To summarize the clinical and imaging findings of the congenital vagal left pulmonary artery (CALPA) and to enhance the understanding of the disease. Methods Five cases of congenital vagal left pulmonary artery confirmed by Zhengzhou Children’s Hospital were retrospectively studied. The selected children underwent X-ray plain film examination and 4 cases underwent color Doppler ultrasound and CT angiography (CTA). Results The clinical manifestations of this group of children with cough, shortness of breath, laryngeal wheeze and breathing difficulties, physical examination three concave positive; X-ray showed two lung blood increased, the heart increased, the two lung patchy, flaky Increased density shadow. Echocardiography see the main pulmonary artery dilatation, left pulmonary artery from the right pulmonary artery, some children with other cardiovascular malformations. CTA angiography showed an increase in both pulmonary blood flow, heart rate to the left atrium and right atrial enlargement, the main pulmonary artery dilatation, the left pulmonary artery from the right pulmonary artery, along the left main bronchial wall posterior lateral extension. Conclusions Ventilation disturbance caused by incomplete airway obstruction is the most prominent clinical manifestation of this disease. Cardiac CTA can simultaneously observe the pulmonary and vascular conditions of patients. Combined with X-ray and echocardiography can provide reliable diagnosis and treatment of this disease The imaging basis.