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动脉导管未闭并左肺动脉缺如误诊1例 总被引:1,自引:0,他引:1
病人 ,女 ,2 5岁。患者出生后易“感冒” ,发育差 ,无发紫、蹲踞。查体 :心率 12 0次 /min ,律齐 ;血压 :左上肢10 5 / 5 0mmHg、右上肢 110 / 6 0mmHg、左下肢 180 / 6 0mmHg、右下肢 180 / 5 5mmHg ,胸骨左缘Ⅱ~Ⅲ肋间可触及双期震颤 ,听诊闻及连续性机械样杂音 ,P2 亢进 ,股动脉闻及枪击音。心电图 :大致正常 ;X线示 :两肺血多 ,主动脉结宽 ,漏斗征 (+) ,肺动脉段突出 ,左心室增大 ,心胸比例 0 6 1。超声示 :左房、左室及右室内径扩大 ,主肺动脉增宽 ,内径达 2 3mm ,左肺动脉与降主动脉间可探及一宽约 4mm ,… 相似文献
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患者 女 ,16岁。活动后心前区不适及体检发现心脏杂音5年。体检 :于左第 3、4肋间闻及广泛收缩期杂音。心电图示ST T改变、异常Q波和电轴左偏。超声心动图疑诊“主动脉窦瘤破入右室”。心脏远达片示心影呈“二尖瓣型” ,左室肥大 ,心胸比率为 0 .5 2 ;左心缘肺动脉段膨隆 ,肺血轻度增多。主动脉根部造影示左冠状窦较右冠状窦小 ,左冠状动脉完全未显。右冠状动脉主干及右心室支明显增粗 (主干直径为0 .8cm)、纡曲 (图 1)。右冠状动脉右前斜位造影示其右心室支末梢增多、增粗、扭曲呈网状与左冠状动脉交通 ;继之左冠状动脉前降支、左冠… 相似文献
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患者 男 ,8岁。自幼因感冒体检发现心脏杂音。查体 :于胸骨左缘 3、4肋间闻及广泛收缩期杂音。无紫绀 ,无咯血 ,活动后轻度乏力 ,心慌、气喘 ,胸痛。心电图 :窦性心律 ,心电图左偏 -10° ,左心室肥厚 ,ST -T缺血改变。超声心动图 :房间隔缺损 ,肺动脉 -冠状动脉瘘。X线示两肺呈多血改变 ,肺动脉段膨隆 ,心胸比率 0 .5。主动脉根部造影见 :主动脉窦形态正常 ,无造影剂返流。右冠状动脉造影见 :右冠状动脉主干及右心室支明显增粗、迂曲。分支末端在心前壁形成毛细血管网 ,造影剂经网状血管到左冠状动脉回流至肺动脉后侧使肺动脉主干及分支… 相似文献
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目的 评价儿童冠状动脉异常起源肺动脉的多层螺旋CT(MSCT)诊断价值.资料与方法 MSCT应用于8例冠状动脉异常起源肺动脉患儿检查中,平均年龄4.12岁(5个月~10岁),其中4例采用无心电门控CT血管成像,MSCT参数:准直0.625~1.25mm,层厚0.625~1.25mm,螺距为0.562,旋转速度0.5s/r,床进5.62mm/r,0.31~0.625mm重建间隔,4例采用回顾性心电门控.结果 8例冠状动脉起始、右冠状动脉近端、左冠状动脉主干、左前降支及左回旋支近端显示率100%.7例左冠状动脉异常起源于肺动脉瓣窦上的肺动脉总干,1例右冠状动脉异常起源于肺动脉总干右后壁,1例伴右上肺静脉异位引流入上腔静脉,1例伴右冠状动脉高位开口.结论 冠状动脉异常起源肺动脉为少见的先天性心脏病,MSCT可作为一种可靠的,有潜力的无创伤性诊断方法 应用于其诊断中. 相似文献
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病例资料患者,女,10岁。出生后发现心脏杂音,易感冒,轻度发绀,哭闹后加重。体检:发育差,心率125次/分,律齐,胸骨左缘第2、3肋间可闻及吹风样收缩期杂音,肺动脉第2音亢进。心电图:右心室肥厚,心房扩大。胸片示两肺血多,肺动脉段凸出,右心室增大,心胸比率0.55。超声心动图:先天性心脏病,右心室双出口、室间隔缺损、房间隔缺损、永存左上腔静脉。右心导管检查:先天性心脏病右室双出口、室间隔缺损(主动脉瓣下)、肺动脉狭窄;主动脉根部造影:冠状动脉左 相似文献
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主动脉弓离断三联症一例 总被引:1,自引:1,他引:1
患者 女,8岁.5年前发现心脏杂音,3年前出现紫绀、蹲踞现象.未见明显差异性紫绀。体捡:心前区略隆起.心界无明显扩大.心音有力,胸骨左缘3、4肋间可闻及3/6级收缩期吹风样杂音.向胸骨右缘传导.P2亢进,X线平片示:肺血增多.左、右肺动脉明显增宽,主动脉结显示不清,肺动脉压安出,心尖圆钝(图1)。 相似文献
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Erkki T. Kaukanen Hannu I. Manninen Pekka J. Matsi Heini K. Söder 《Cardiovascular and interventional radiology》1997,20(5):353-358
Purpose: To evaluate the suitability of transbrachial access for endovascular renal artery interventions.
Methods: During 37 consecutive endovascular renal artery interventions, the transbrachial approach was used on nine patients (mean
age 63 years; range 41–76 years) for 11 renal artery procedures on native kidneys and one percutaneous transluminal angioplasty
(PTA) on a transplanted kidney. The reason for using transbrachial access was a steep aorta-renal angle in five, and severe
aorta-iliac atherosclerosis in the remaining patients. In addition to the intervention catheter in the left brachial artery,
an additional nonselective catheter for controlling the procedure was inserted transfemorally (six patients) or via the contralateral
brachial artery.
Results: Eleven interventions (six PTAs, five stents) were successfully completed. The one failure resulted from impenetrable subclavian
artery stenosis. The only major complication was a brachial artery pseudoaneurysm requiring surgical treatment.
Conclusion: Transbrachial access is an effective and relatively safe technique for renal artery interventions when transfemoral access
is not possible.
Received: 0/00/00/Accepted: 0/00/00 相似文献
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Chung HH Cha SH Cho SB Kim JH Lee SH Shin JS Park SW 《Cardiovascular and interventional radiology》2006,29(2):294-297
This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the
axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection
and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly
diagnosed with the following sonogram. 相似文献
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《Journal of vascular and interventional radiology : JVIR》2023,34(5):938-938.e1
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《Journal of vascular and interventional radiology : JVIR》2014,25(9):1363-1368
PurposeTo evaluate the efficacy and safety of a dual femoral–popliteal approach in the supine position after failed antegrade recanalization attempts in chronic total occlusion (CTO) of the superficial femoral artery (SFA).Materials and MethodsFrom May 2011 to October 2012, 21 patients underwent dual femoral–popliteal recanalization for CTO of the SFA, with a mean lesion length of 87.4 mm ± 5.8. When contralateral antegrade recanalization of SFA occlusions via the common femoral artery could not be achieved, the occlusions were intrainterventionally accessed by retrograde approach via the popliteal artery, which was punctured anteriorly with gently flexed knee and crus extorsion. When the SFA had been recanalized, further angioplasty and stent placement procedures were completed via the femoral artery.ResultsA technical success rate of 100% (entailing puncture of the popliteal artery and SFA recanalization) was achieved, and no hemorrhage, hematoma, pseudoaneurysm, arteriovenous fistula, or other complications developed. During a mean follow-up of 9.8 months ± 1.5, claudication severity, rest pain, and toe ulcers improved significantly. The pulse of the distal arteries, as well as the filling of the veins, could be distinctly felt. Ankle-brachial index changed from 0.48 ± 0.17 to 0.84 ± 0.11 at 1 year after intervention (P < .001), and patency rates at 1, 6, and 12 months after interventions were 100%, 80%, and 42%, respectively.ConclusionsA dual femoral–popliteal approach in the supine position is an alternative backup option after failed attempts at the antegrade approach for patients with proximal barriers in CTO or lesions with major extending collateral vessels. 相似文献
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患者 男 ,66岁。胸闷、气短 ,间断发作 9年 ,症状逐渐加重 ,伴气短及胸前区压榨感 ,按冠心病、心绞痛治疗后症状缓解。彩色多普勒显示左心室功能下降。冠状动脉造影显示左主干管状扩张 ,左前降支发出对角支之后形成囊样改变 (图 1)。SCT三维血管成像显示肺动脉圆锥左前方大小约 18mm的类圆形瘤样扩张影 (图 2 ) ,瘤体与左冠状动脉前降支之间可见大量迂曲成团的动脉血管影 ,紧贴肺动脉干分布 ,并与左前降支相连 (图 3 )。瘤体与冠状动脉根部有一细小血管影 ,该血管末端直径约 1.3mm ,其右 (外 )侧有一较粗大右冠状动脉血管 ,可见与瘤体交… 相似文献
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正常肺动脉和肺动脉高压的磁共振成像研究 总被引:2,自引:0,他引:2
目的 确定MRI评价正常肺动脉和肺动脉高压 (PAH)病因及其顺应性变化的价值。材料与方法 在GEVectra 0 .5T超导MR仪上采用肺动脉长轴对正常组 ( 2 3例 ,年龄 10~ 79岁 )和PAH组 ( 2 1例 ,年龄 2~ 66岁 )进行SE和CineMRI检查 ,以测量其管径和顺应性改变 ,并辅以其他成像平面以确定PAH的病因。结果 正常组采用SE测量的管径值为 :肺动脉主干 (MPA) 2 .5 4cm±0 .2 3cm、右肺动脉 (RPA) 1.74cm± 0 .2 3cm、左肺动脉 (LPA) 1.77cm± 0 .2 9cm ,采用CineMRI测得的顺应性为 :MPA 12 %、RPA 16%、LPA13 % ;18例经心导管、造影和 /或手术证实有PAH者MRI均很好显示出其原发病变 ,2例慢性阻塞性肺部疾病 (COPD)和 1例原发PAH者MRI也显示中央肺动脉显著扩张和右室肥厚。经测量PAH组MPA、RPA和LPA管径较正常组增宽明显 ,其顺应性下降显著 ,经t检验 ,两组差异具有非常显著意义 (P <0 .0 0 1)。结论 MRI对确定PAH产生的原因及其顺应性变化具有重要价值 相似文献
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