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主动脉弓离断的临床X线表现 附7例分析 |
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唐郁宽 张群 李国业 谈文开 陆骊工 杨向太
【摘要】 目的 探讨先天性主动脉弓离断(IAA)的临床X线特点及X线平片诊断价值。材料和方法 回顾性分析7例(男3例，女4例，年龄30天～11岁，平均4岁)经心血管造影(ACG)和(或)手术证实的IAA患儿的临床、X线和ACG表现及相互关系。结果 7例全属A1型，无B、C型，均合并心内畸形，术前X线平片符合诊断3例。主要的X线征象有：①气管居中(7例)；②主动脉结消失(7例)；③主动脉弓低位征(2例)；④升主动脉发育不良(4例)；⑤右上肺纵隔旁侧支循环血管影(6例)。结论 X线平片诊断IAA有局限性，但紧密结合临床可提示诊断，临床+X线+多普勒超声心动图(DE)的诊断模式可减少误(漏)诊率，确诊靠ACG，对有造影禁忌证者，可采用MR来确诊。
【关键词】 主动脉弓离断 先天性 X线摄影术 心血管造影术
Clinical X-ray manifestations of interruption of aortic arch (Analysis of 7 cases)
Tang Yukuan Zhang Qun Li Guoye
（Department of Radiology, Panyu People's Hospital of Guangdong province, Panyu 511400）
【Abstract】 Objective To investigate the clinical X-ray characteristics and the capability of X-ray plain film in the diagnosis of congenital interrupted aortic arch(IAA). Methods The clinical, X-ray and Angiocardiography(ACG) features and their interrelations in 7 IAA cases(3 males and 4 females with ages ranged between 30 days and 11 years and an average of 4 years) were retrospectively analyzed. All cases were confirmed by ACG and/or surgery. Results All of the 7 cases belonged to type A1, without type B or type C. All cases were associated intra-cardiac deformity. X-ray plain film features were:①trachea in the middle (7 cases); ②aortic knob disappeared (7 cases); ③“low arch” sign (2 cases);④hypoplastic ascending aorta (4 cases);⑤shadows of bypass circulatory blood vessels beside upper right mediastinum (6 cases). Conclusion There are limitations in the X-ray plain film diagnosis of IAA, but it will be helpful for diagnosis in close clinical adoption. The diagnostic pattern of “clinical+X-ray+Doppler echocardiogram(DE)” may decrease the rate of misdiagnosis, Diagnosis may be made with ACG. For patients with contraindication of angiography, MR may be adopted in diagnosis.
【Key words】 Interrupted aortic arch Congenital Radiography Angiocardiography
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