摘要
目的通过对比分析异常体动脉供血正常左肺下叶的临床、病理表现与影像表现,提高对本病的认识及诊断水平。方法回顾性分析6例异常体动脉供血正常左肺下叶的临床及病理表现,并与影像表现对比分析。结果 (1)临床表现:咯血5例(83%),咳嗽2例(33%),无症状1例(17%)。6例(100%)患者段或段以上支气管分布及形态正常。(2)病理表现:6例(100%)见粗大异常动脉起源于降主动脉左侧。6例(100%)左下肺动脉在背段动脉起始远侧缺如。6例(100%)大体标本切面见多个扩张血管,镜下肺组织部分区域见大小不等厚壁血管,肺泡腔内有多量含铁血黄素,间质内见血管扩张、充血及灶性出血。(3)影像表现:心影后与降主动脉相连的血管样阴影6例,左肺下叶基底段体积缩小6例,呈毛玻璃影6例。左下肺动脉在背段动脉起始远侧缺如6例。异常动脉直径约为12mm。结论异常体动脉供血正常左肺下叶的常见临床表现为咯血,病理表现为异常动脉供血导致基底段肺充血,CT增强扫描可确诊该病。
Objective To improve the diagnosis of anomalous arterial supply to the normal basal segments of left lower lobe by comparative analysis of the clinical, pathological and radiological manifestations. Methods The clinical, pathological, and radiological manifestations of 6 patients with anomalous arterial supply to the normal basal segments of left lower lobe were retrospectively analyzed. Results （1） Clinical manifestations： 5 cases （83%） had hemoptysis. 2 cases （33%） had cough. One case （17%） had no symptom. 6 cases （100%） had normal bronchi. （2） Pathological manifestations： The aberrant artery from the left side of the descending aorta was found in 6 cases. The dilation of blood vessels was shown in the gross specimen section of 6 cases. The various thick-walled vessels, hemosiderin in alveolar space, interstitial congestion, and focal hemorrhage were demonstrated in 6 cases. （3） Radiological manifestations：Retrocardiac vessel-like shadows connecting to the descending aorta were found in 6 cases. The volume of the left lower lobes with ground-glass opacities was reduced in 6 cases. The interlobar arteries distal to the origin of the superior segmental artery were absent in 6 cases. The aberrant artery was approximately 12mm in diameter. Conclusion Common clinical manifestation of anomalous arterial supply to the normal basal segments of left lower lobe was hemoptysis caused by basal segment pulmonary congestion. Anomalous arterial supply to the normal basal segments of left lower lobe could be diagnosed by enhanced CT scan.
出处
《中国CT和MRI杂志》
2014年第3期55-58,74,共5页
Chinese Journal of CT and MRI
