1 Both authors: Department of Diagnostic Radiology, Montreal General Hospital, McGill University Health Center, 1650 Cedar Ave, Montreal, QC H3G 1A4, Canada.
AJR Am J Roentgenol. 2014 Sep;203(3):594-600. doi: 10.2214/AJR.13.11689.
The purpose of this study was to show the arrangement and connections of the bronchopulmonary veins (i.e., vessels draining the bronchi, bronchioles, and pleura in patients with chronic superior vena cava (SVC) or left brachiocephalic vein (LBCV) obstruction using CT.
Contrast-enhanced CT scans of the chest of 16 patients with chronic SVC or LBCV obstruction were analyzed retrospectively. Scans were acquired using various standard protocols. The mean age of the patients (10 men and six women) was 63 years (range, 41-86 years). The causes of obstruction were malignancy (7/16, 44%), catheter-related thrombosis (7/16, 44%), chronic fibrosing mediastinitis (1/16, 6%), and unknown (1/16, 6%).
The following sites were obstructed: SVC (9/16, 56%), SVC below the azygos vein (4/16, 25%), and lower LBCV (3/16, 19%). The bronchopulmonary veins were opacified via the brachiocephalic, azygos, or accessory hemiazygos veins or their branches. We observed long vessels that could be traced along the lateral mediastinum or alongside the trachea and central bronchi to their termination in the central pulmonary veins from the level of the ostia to segmental divisions. These vessels intercommunicated and gave rise to smaller veins contiguous with the walls of the bronchi and pulmonary arteries. The pulmonary venous connections of the bronchopulmonary veins were more frequent with the lower lobe pulmonary veins. Pericardial and esophageal veins were also opacified through the brachiocephalic or azygos veins and anastomosed commonly with the bronchopulmonary veins.
The arrangement and connections of the bronchopulmonary veins in patients with chronic SVC or LBCV obstruction can be depicted by CT; these vessels form an intricate network connecting the systemic and pulmonary venous circulations and can act as systemic-pulmonary shunts.
本研究旨在通过 CT 显示慢性上腔静脉（SVC）或左头臂静脉（LBCV）阻塞患者支气管肺静脉（即引流支气管、细支气管和胸膜的血管）的排列和连接。
回顾性分析 16 例慢性 SVC 或 LBCV 阻塞患者的胸部增强 CT 扫描。使用各种标准方案采集扫描。患者的平均年龄（10 名男性和 6 名女性）为 63 岁（范围为 41-86 岁）。阻塞的原因是恶性肿瘤（16 例中的 7 例，44%）、导管相关血栓形成（16 例中的 7 例，44%）、慢性纤维性纵隔炎（16 例中的 1 例，6%）和未知原因（16 例中的 1 例，6%）。
以下部位受阻：SVC（16 例中的 9 例，56%）、SVC 下腔静脉（16 例中的 4 例，25%）和下 LBCV（16 例中的 3 例，19%）。支气管肺静脉通过头臂静脉、奇静脉或副奇静脉或其分支显影。我们观察到可以沿着侧纵隔或沿着气管和中央支气管追踪的长血管，直到它们在中央肺静脉的水平终止于中央肺静脉。这些血管相互沟通，并产生与支气管和肺动脉壁相邻的较小静脉。支气管肺静脉的肺静脉连接更常见于下叶肺静脉。心包和食管静脉也通过头臂静脉或奇静脉显影，并与支气管肺静脉通常吻合。
CT 可显示慢性 SVC 或 LBCV 阻塞患者支气管肺静脉的排列和连接；这些血管形成连接体循环和肺循环的复杂网络，并可作为体肺分流。
