肺动脉闭锁伴室间隔缺损的多层螺旋CT诊断

目的:回顾性分析肺动脉闭锁伴室间隔缺损(PAVSD)的多层螺旋CT(MSCT)表现。方法:分析5例肺动脉闭锁伴室间隔缺损患者的MSCT图像。4例行平扫及双期扫描,另1例行单期扫描。结合薄层图像、多平面重组、薄层最大密度投影以及容积再现法进行观察。结果:MSCT显示肺动脉瓣闭锁2例,肺动脉干中断、无中央共汇者3例。5例均见室间隔缺损。2例见明显的支气管动脉扩张;2例见直接主动脉肺动脉侧支;2例见间接主动脉肺动脉侧支。1例合并右心室发育不良及三尖瓣狭窄,1例合并房间隔缺损;3例合并右位主动脉弓,2例合并主动脉后左无名静脉。1例有手术史者可见上腔静脉与右肺动脉吻合,与右心房无交通。结论:MSCT可清楚地显示PAVSD的主要表现。

Multislice CT Findings of Pulmonary Atresia with Ventricular Septal Defect

Objective:To describe multislice CT findings of pulmonary atresia with ventricular septal defect (PAVSD).Methods:Non-contrast enhanced MSCT scans and biphasic contrast enhanced MSCT scans (n=4) and a monophasic contrast enhanced MSCT scan of five patients with PAVSD were retrospectively evaluated.The presence and location of pulmonary atresia,the presence of central confluences,the presence,origin,course and distribution of aorto-pulmonary collateral vessels and the patterns of intrapulmonary arteries were evaluated with reformatted thin-slice images,MPR and thin-slab MIP on MSCT.Associated anomalies,varieties and postoperative changes when there was a history of surgery were also noted.Results:The central pulmonary arteries and central confluences could be identified in 2 patients with pulmonary valvular atresia while no central pulmonary arteries and central confluences were noted in the other 3 patients.Ventricular septal defect (VSD) was identified in 5 patients.Collateral arteries from bronchial arteries,direct and indirect aortopumonary collateral vessels were identified each in 2 patients,respectively.A hypoplastic right ventricle combined with tricuspid stenosis (n=1),atrial septal defect (ASD) (n=1),right aortic arch (n=3) and postaortic left innominate vein (n=2) were also noted.Anastomosis of superior vena cava and right pulmonary artery was identified in one patient with a history of surgery.Conclusion:Main MSCT findings of PAVSD include pulmonary valvular atresia or absence of central pulmonary arteries and/or central confluences,VSD,collateral arteries of varied origin,course and distribution and associated anomalies and varieties such as right ventricle hypoplasia,ASD,right aortic arch and postaortic left innominate vein.