先天性单侧肺动脉缺如25例影像学诊断

目的:评价先天性一侧肺动脉缺如(UAPA)多排螺旋CTA的影像学诊断价值。方法:回顾分析25例我院明确诊断为先天性一侧肺动脉缺如的胸X线片、经胸超声心动图检查、胸部多排螺旋CTA及心血管造影表现。结果:15(15/25)例为右肺动脉缺如,10(10/25)例为左肺动脉缺如。单发UAPA 4例,均为右肺动脉缺如。UAPA合并其他心血管畸形21例,其中合并简单心血管畸形9例,合并复杂畸形12例,简单畸形中包括动脉导管未闭、房间隔缺损、室间隔缺损等,复杂畸形中包括肺动脉闭锁、法洛四联症各4例,肺动脉狭窄3例,另有大动脉转位等。9例经外科手术证实,12例经心血管造影证实。结论:对于一侧肺动脉缺如的诊断,多排螺旋CTA检查作为一种无创的检查方法与心血管造影同样具有明确诊断价值,CTA所显示的客观的解剖结构,为治疗方案的选择提供依据。

The role of multi-slice spiral CT angiography in the evaluation of unilateral absence of pulmonary artery

Objective:To explore the value of multi-slice spiral CT angiography in diagnosing unilateral absence of pulmonary artery(UAPA).Methods: 25 cases with UAPA diagnosed in our hospital were analyzed retrospectively by chest radiograph,echocardiograph,multi-slice spiral CT angiography(MDCTA) and cardiovascular angiography.Results: Of 25 cases identified,we found 15 patients of the right pulmonary artery was absent,while the left was absent in 10 of patients.Including our own cases,we found a total of 4 patients with UAPA of the right pulmonary artery without associated cardiac anomalies,while 21 patients with other congenital cardiac anomalies.9 patients with simple congenital cardiac anomalies,including Patent ductus arteriosus,Atrial septal defect and ventricular septal defect.12 patients with Complex malformation,including 4 patients with pulmonary atresia,4 patients with Tetralogy of Fallot and 3 patients with pulmonic stenosis.9 cases underwent different surgical interventions.12 cases identified by percutaneous cardiovascular angiography.Conclusion: Both MDCT angiography and Cardiovascular angiography are valuable tools for patients with UAPA,and MDCT as a tool without invasive could offer more anatomy information for the therapy.