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诊断影像学临床(155)。偶然发现的动脉导管未闭伴继发性肺动脉高压。

Clinics in diagnostic imaging (155). Incidental PDA with secondary pulmonary arterial hypertension.

作者信息

Mak May San, Ong Ching Ching, Tay Edgar Lik Wui, Teo Lynette Li San

机构信息

Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.

出版信息

Singapore Med J. 2014 Sep;55(9):462-6; quiz 467. doi: 10.11622/smedj.2014113.

Abstract

We report the case of a 70-year-old man with an asymptomatic large patent ductus arteriosus (PDA) incidentally detected on triple-rule-out computed tomography (CT). CT clearly demonstrated a vascular structure connecting the descending thoracic aorta to the roof of the proximal left pulmonary artery, consistent with a PDA. Secondary pulmonary arterial hypertension was also evident on CT. The patient was eventually diagnosed with acute coronary syndrome and was successfully treated with coronary artery bypass graft surgery and concomitant patch closure of the PDA. This article aims to outline the imaging features of PDA and highlight the information provided by CT, which is crucial to treatment planning. The pathophysiology, clinical manifestations and closure options of PDA are also briefly discussed.

摘要

我们报告一例70岁男性患者,其在三联排除计算机断层扫描(CT)中偶然发现有无症状的大型动脉导管未闭(PDA)。CT清晰显示一个连接胸降主动脉与左肺动脉近端顶部的血管结构,符合动脉导管未闭表现。CT上还可见继发性肺动脉高压。该患者最终被诊断为急性冠状动脉综合征,并成功接受了冠状动脉搭桥手术及同期PDA修补术。本文旨在概述PDA的影像学特征,并强调CT所提供的信息,这对治疗方案的制定至关重要。同时还简要讨论了PDA的病理生理学、临床表现及闭合方法。

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