Stević Ruza, Mandarić Dragan, Jovanović Dragana, Vasić Nada, Masulović Dragan, Mujović Natasa
Klinicki centar Srbije, Beograd, Institut za radiologiju.
Med Pregl. 2009 May-Jun;62(5-6):278-80. doi: 10.2298/mpns0906278s.
Pulmonary sequestration is a non-functioning pulmonary parenchyma that is separated from tracheobronchial tree and receives its blood supply via systemic arteries. The diagnosis of sequestration pulmonis is based on clinical symptoms and characteristic radiologic findings.
In this report, radiological findings of pulmonary sequester in three patients with non-resolving pneumonia were retrospectively reviewed. All patients underwent chest x-ray, computerized tomography of thorax and angiography. X-ray revealed in all cases tumorlike, unsharply bordered shadows in the posterior basal parts of the lung, two on the right and one on the left side. Computerized tomography (CT) finding showed solid-cystic tumor masses and angiography revealed anomalous blood supply from systemic arteries arising from aorta and running to the shadow in the lung. This finding is typical of bronchopulmonary sequestration. All patients were operated on and histological analysis of operative material confirmed diagnosis of intralobar pulmonary sequestration.
Sequestration pulmonis can cause a diagnostic problem due to unspecific symptoms and atypical radiographic and CT findings. Therefore, it is important to demonstrate the arterial supply and venous drainage of the sequestered segment preoperatively. Today, with the help of non-invasive imaging techniques such as CT and magnetic resonance imaging (MRI), preoperative diagnosis of pulmonary sequester can be made easily, so, invasive techniques such as angiography are not required frequently.
肺隔离症是一种无功能的肺实质,与气管支气管树分离,并通过体循环动脉获得血液供应。肺隔离症的诊断基于临床症状和特征性影像学表现。
在本报告中,回顾性分析了3例非 resolving 肺炎患者肺隔离症的影像学表现。所有患者均接受了胸部X线、胸部计算机断层扫描和血管造影检查。X线检查在所有病例中均显示肺后基底段有肿瘤样、边界不清的阴影,右侧2例,左侧1例。计算机断层扫描(CT)显示实性囊性肿瘤肿块,血管造影显示来自主动脉的体循环动脉异常供血并延伸至肺部阴影。这一表现是肺叶内型肺隔离症的典型表现。所有患者均接受了手术治疗,手术标本的组织学分析证实了叶内型肺隔离症的诊断。
由于症状不特异以及影像学和CT表现不典型,肺隔离症可能会导致诊断困难。因此,术前显示隔离段的动脉供血和静脉引流非常重要。如今,借助CT和磁共振成像(MRI)等非侵入性成像技术,可以轻松进行肺隔离症的术前诊断,因此,血管造影等侵入性技术并不经常需要。