主动脉缩窄合并右弓右降及多囊状动脉瘤的影像诊断

目的 研究主动脉缩窄合并右弓右降及多囊状动脉瘤的的影像学表现。方法 回顾性分析2例主动脉缩窄合并右弓右降及多囊状动脉瘤x线胸片、超声心动图、心血管造影、三维动态增强磁共振造影(3DDCEMRA)资料并与手术病理结果对照。结果 两例均为镜面右位主动脉弓(Ⅰ型)、主动脉缩窄、主动脉弓部多囊状动脉瘤。结论 心血管造影是诊断该类复杂畸形最可靠的方法，三维动态增强磁共振造影(3DDCEMRA)在一定程度上可以替代心血管造影，能为临床手术提供明确的定位与定性诊断。

Imaging Diagnosis of Congenital Coarctation of the Aorta Complicated with Right Aortic Arch and Multisaccular Aneurysm of the Proximal Descending Aorta

Objective To evaluate the imaging features of congenital coarctation of the aorta complicating right aortic arch and multisaccular aneurysm of the proximal descending thoracic aorta. Methods Two cases of coarctation of the aorta complicating right aortic arch and multisaccular aneurysm of the proximal descending aorta, confirmed by operation and pathology, were analyzed retrospectively, including clinical manifestations, chest films, echocardiography, aortic angiography and 3 Dimension Dynamic Contrast enhanced Magnetic Resonance Angiography (3D DCE MRA) scanning. Results Aortic angiography and 3D DCE MRA showed multisaccular aneurysm of the proximal descending thoracic aorta associated with coarctation of the aorta and mirror image right aortic arch with (type I). Both cases were misdiagnosed by color Doppler echocardiography and X ray plain film. Conclusion Angiocardiography is the most reliable method in the diagnosis of this complex anomaly. To a great extent, 3D DCE MRA will obviate angiocardiographic confirmation and provide explicit localization and qualitative information for clinical operation.