咯血患者肺外体循环动脉供血的CT血管造影

目的探讨咯血患者肺外体循环动脉(ESCA)供血的CT血管成像(CTA)表现及其与胸膜增厚的关系。资料与方法回顾性分析233例咯血患者的影像学资料,通过数字减影血管成像(DSA)明确咯血责任血管的来源和数量,分析ESCA的CTA表现及其与胸膜增厚的关系。结果 233例咯血患者中,84例(36.1%)存在ESCA供血,共318支,包括肋间后动脉171支,锁骨下动脉分支56支,胸廓内动脉分支47支,腋动脉分支23支,腹主动脉分支21支;CTA表现为管径增粗、走行纡曲,发出分支至病灶区域参与供血,部分与肺动脉或供血支气管动脉相互吻合形成血管网。84例有ESCA供血患者中,82例(97.62%)伴有靶胸膜增厚;149例无ESCA供血患者,90例(60.40%)伴有靶胸膜增厚;有ESCA供血患者伴靶胸膜增厚率高于无ESCA患者(χ2=36.60,P<0.01),且ESCA来源与靶胸膜增厚部位之间存在对应关系。结论 ESCA是重要的咯血责任血管,其数目、来源与病灶部位及胸膜增厚密切相关。

CT Angiography of Extrapulmonary Systemic Circulation Artery Blood Supply in Hemoptysis Patients

Purpose To investigate CT angiography(CTA) manifestations of extrapulmonary systemic circulation artery(ESCA) in hemoptysis patients and its relationship with pleural thickening. Materials and Methods Imaging data of 233 hemoptysis patients were retrospectively analyzed. Digital subtraction angiography(DSA) was taken to confirm source and number of vessels responsible for hemoptysis to analyze CTA manifestations of ESCA and its relationship with pleural thickening. Results For 233 hemoptysis patients, there were 84 cases(36.1%) with ESCA blood supply, totally 318 ESCAs, including 171 branches from posterior intercostal artery, 56 branches from subclavian artery, 47 branches from thoracic artery branch, 23 branches from auxiliary artery branch and 21 branches from abdominal aorta. CTA manifestations included enlarged diameter and circuitous extension, branches extended to lesions involving blood supply. Some branches match pulmonary arteries or blood supply arteriae bronchiales forming vascular network, among the 84 patients with ESCA blood supply patients, there were 82(97.62%) combined targeted pleural thickening. Among the 149 patients with ESCA blood supply patients, there were 90(60.40%) combined targeted pleural thickening. Rate of targeted pleural thickening in ESCA blood supply patients was higher than patients without ESCA blood supply(χ2=36.60, P<0.01). Meanwhile, there was corresponding relations between ESCA source and targeted pleural thickening. Conclusion ESCA is important vessels responsible for hemoptysis and the number, source and lesion location are closely related to pleural thickening.