Jaffe R B
Circulation. 1975 Oct;52(4):714-21. doi: 10.1161/01.cir.52.4.714.
The radiographs of 21 patients with complete interruption of the aortic arch are reviewed, together with the literature, to emphasize characteristic radiographic features previously not recognized or discussed. In addition to the nonspecific radiologic findings of a left-to-right shunt through the invariably present ventricular septal defect, charateristic and unique features noted on chest radiograph and barium swallow that may suggest the diagnosis prior to catheterization include: a) a midline trachea; b) a hypoplastic ascending aorta with direct vertical ascent toward the neck; c) absence of the aortic "knob;" d) termination of the descending thoracic aortic shadow at the level of the main pulmonary artery; e) a "low arch" on lateral or left anterior oblique projections; and f) absence of the normal aortic impression on the barium-filled esophagus. Rib notching, when present, in association with the above findings indicates a stenotic or closed ductus arteriosus with collateral circulation through intercostal arteries to the descending aorta. The bilateral or unilateral location, right or left side, of the notching is dependent on the site of interruption and origin of the subclavian arteries and may permit differentiation into types and subtypes on chest radiograph.
回顾了21例主动脉弓完全中断患者的X线片，并结合文献，以强调此前未被认识或讨论过的特征性X线表现。除了通过始终存在的室间隔缺损从左向右分流的非特异性放射学表现外，胸部X线片和食管吞钡检查中发现的可能在导管插入术前提示诊断的特征性和独特表现包括：a）气管位于中线；b）升主动脉发育不全，直接垂直向上延伸至颈部；c）主动脉“结”缺如；d）降主动脉阴影在主肺动脉水平终止；e）侧位或左前斜位投影显示“低弓”；f）钡剂充盈的食管上正常主动脉压迹缺如。肋骨切迹若存在，结合上述表现提示动脉导管狭窄或闭合，伴有通过肋间动脉至降主动脉的侧支循环。肋骨切迹的双侧或单侧位置、右侧或左侧，取决于中断部位和锁骨下动脉的起源，这可能有助于在胸部X线片上区分类型和亚型。
