上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (9): 1312-.doi: 10.3969/j.issn.1674-8115.2011.09.023

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血管环伴气管狭窄的多层螺旋CT诊断

王 谦, 钟玉敏, 孙爱敏, 杜 隽, 朱 铭   

  1. 上海交通大学 医学院附属上海儿童医学中心影像诊断中心, 上海 200127
  • 出版日期:2011-09-28 发布日期:2011-09-27
  • 作者简介:王 谦（1974—）, 男, 副主任医师, 学士；电子信箱: wangqian7472@yahoo.com.cn。

Multislice CT in diagnosis of vascular rings with tracheal stenosis

WANG Qian, ZHONG Yu-min, SUN Ai-min, DU Jun, ZHU Ming   

  1. Imaging Diagnosis Center, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-09-28 Published:2011-09-27

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摘要：

目的 探讨多层螺旋CT在由血管环畸形造成气管狭窄中的诊断价值。方法 回顾性分析99例血管环畸形的多层螺旋CT影像资料，行最大密度及最小密度投影重建观察异常走行的血管及有无气管狭窄。结果 52例肺动脉吊带中有46例伴有气管狭窄，CT表现为左肺动脉异常起源于右肺动脉，向后向左走行于气管和食管之间，致使左肺动脉环绕并压迫气管，造成气管狭窄。22例双主动脉弓中18例伴有气管狭窄，CT表现为升主动脉在气管前分左、右主动脉弓，分别跨过左、右支气管在气管后方汇合，形成完整的血管环。1例右弓伴食管后动脉导管伴有气管狭窄，CT表现为主动脉弓位于气管右侧，动脉导管起源于降主动脉近端，并向左走行于食道后方，绕过食道后向前连接于左肺动脉起始部，形成血管环。24例右弓、迷走左锁骨下动脉、左侧动脉导管或动脉导管韧带中18例伴有气管狭窄，CT表现为右弓、迷走左锁骨下动脉及左侧动脉导管或动脉导管韧带三者包绕气管及食管形成血管环。结论 血管环畸形常伴有气管狭窄，多层螺旋CT既能很好地显示大血管异常解剖结构，也能精确的评价气管狭窄的情况。

关键词: 血管环, 气管狭窄, 多层螺旋CT

Abstract:

Objective To investigate the value of multislice CT in the diagnosis of tracheal stenosis caused by vascular ring malformation. Methods The imaging data of multislice CT of 99 cases of vascular ring malformation were retrospectively analysed. Maximum and minimum density project reconstructions were performed to observe the abnormal blood vessels and presence of tracheal stenosis. Results Forty-six of 52 cases of pulmonary sling were associated with tracheal stenosis, and it was illustrated by CT that the left pulmonary artery derived from the right pulmonary artery, extended backward and leftward between trachea and esophagus, encircled and compressed trachea to cause tracheal stenosis. Eighteen of 22 cases of double aortic arch were associated with tracheal stenosis, and it was illustrated by CT that the ascending aorta branched into left aortic arch and right aortic arch in front of trachea, merged in back of trachea after crossing left bronchus and right bronchus respectively and formed the vascular ring. One case of right aortic arch with persistent left ligament was associated with tracheal stenosis, and it was illustrated by CT that the aortic arch located right to the trachea, the arterial ductus derived from the proximal end of descending aorta, extending leftward in back of esophagus, and joined the origin of the left pulmonary artery to form the vascular ring. Eighteen of 24 cases of right aortic arch with aberrant left subclavian artery and left arterial ductus were associated with tracheal stenosis, and it was illustrated by CT that right aortic arch, aberrant left subclavian artery and left arterial ductus encircled the trachea and esophagus to form the vascular ring. Conclusion Vascular ring malformation is usually accompanied by tracheal stenosis. Multislice CT can well demonstrate the anatomy of vascular anomalies, and may have a precise evaluation of tracheal stenosis.

Key words: vascular ring, tracheal stenosis, multislice computed tomography