肺动静脉畸形的影像诊断(附18例分析)

目的：探讨肺动静脉畸形PAVMs相关影像检查方法的诊断价值。方法：回顾分析18例PAVMs的影像学表现，其中9例经手术病理证实，9例临床表现典型并经相关影像检查确诊。结果：18例PAVMs中，单发病灶11例，双发病灶2例，多发病灶5例。18例行X线检查，诊断符合率为72．2％；CT平扫7例，诊断符合率为85．7％；5例肺动脉造影，诊断符合率为100％。结论：瘤样扩张的血管囊腔与其相连的供血动脉和引流静脉血管为PAVMs的其本构筑，X线检查与CT平扫对征象典型的病例可作出诊断，对征象不典型和多发性病变诊断有限度。肺动脉造影是检查和诊断本病的金标准，能为手术治疗提供可靠的指征。螺旋CT增强扫描和三维重建是诊断PAVMs理想和无创伤的影像检查方法。

The imaging diagnosis of pulmonary arteriovenous malformations(analysis of 18 cases)

Objective:To explore the related diagnostic values of imaging examination methods in pulmonary arteriovenous malformations(PAVMs).Methods:The imaging manifestations of eighteen cases were confirmed by operative pathology,other 9 cases were diagnosed by typical clinical manifestations and related imaging examinations.Results:18 cases of PAVMs,the single focus in 11 cases,dual lesions in 2 cases,the multiple lesions in 5 cases.18 cases examination with X ray,the diagnostic agreement rate(DAR) was 72.7%;CT plain scan in 7 cases,the DAR was 85.7%;pulmonary arteriography in 5 cases,the DAR was 100%. Conclusion:The tumor like dilatation of the vascular sac cavity connected with the feeding artery and drainage venous was the basic structure of PAVMs,the X ray and CT plain scan can made the diagnosis for the cases possess the typical signs,but for the atypical and multiple lesions,the diagnostic accurary is limited.The pulmonary arteriography is the golden standard for the PAVMs examination,and provided the availible evidence for the operative therapy.The spiral enhancement CT can and the three dimensional reconstruction are the ideal and noninvasive imaging examination methods for the diagnosis of PAVMs.