Byun Sung Su, Park Jae Hyung, Kim Jeong Ho, Sung Yon Mi, Kim Yoon Kyung, Kim Eun Young, Park Eun Ah
Department of Radiology, Gachon University Gil Hospital, 1198, Guwol 1-dong, Namdong-gu, Incheon, 405-760, Korea.
Int J Cardiovasc Imaging. 2015 Jun;31 Suppl 1:69-75. doi: 10.1007/s10554-015-0647-5. Epub 2015 Mar 24.
To describe the coronary CT findings of coronary-to-bronchial artery communication (CBAC) in chronic pulmonary disease. Coronary CT was performed in 15 patients with chronic pulmonary disease using 64-channel or greater multidetector CT. Among those patients, one or two CBACs were identified. A retrospective analysis of the CT findings was done to determine the originating artery, arterial course of the communications and other associated results. The main underlying pulmonary disease was bronchiectasis (n = 12). The origin of the CBAC was from the left atrial (n = 7) or sinoatrial (SA) nodal (n = 3) branch of the left circumflex artery in nine patients and the SA nodal branch of the right coronary artery in six patients. The CBAC was connected to the left bronchial artery in 11 patients and the right bronchial artery in five patients. The course of the CBAC passed through the interpulmonary venous bare area between reflections of the serous pericardium of the transverse and oblique sinuses in 13 patients. In three patients, it passed through the perivascular space around the left upper or lower pulmonary vein. In one patient, there were two communications-one through the interpulmonary venous bare area and the other through the perivascular space around the left lower pulmonary vein. There was no significant coronary arterial stenosis except in two patients. Bronchial arterial hypertrophy was found in all 15 patients. Detailed analysis of coronary CT can be a helpful guide for hemodynamic significance and clinical management including embolotherapy for CBAC in patients of chronic pulmonary disease with hemoptysis.
描述慢性肺部疾病中冠状动脉至支气管动脉交通（CBAC）的冠状动脉CT表现。对15例慢性肺部疾病患者使用64排及以上多层螺旋CT进行冠状动脉CT检查。在这些患者中，发现了一或两个CBAC。对CT表现进行回顾性分析，以确定起源动脉、交通支的动脉走行及其他相关结果。主要的基础肺部疾病为支气管扩张（n = 12）。9例患者的CBAC起源于左旋支动脉的左心房（n = 7）或窦房（SA）结（n = 3）分支，6例患者的CBAC起源于右冠状动脉的SA结分支。11例患者的CBAC与左支气管动脉相连，5例患者的CBAC与右支气管动脉相连。13例患者的CBAC走行穿过横窦和斜窦浆膜心包反折之间的肺静脉裸区。3例患者的CBAC穿过左上或左下肺静脉周围的血管周围间隙。1例患者有两个交通支——一个穿过肺静脉裸区，另一个穿过左下肺静脉周围的血管周围间隙。除2例患者外，均无明显冠状动脉狭窄。15例患者均发现支气管动脉肥大。对冠状动脉CT进行详细分析有助于指导血流动力学意义及临床管理，包括对咯血的慢性肺部疾病患者的CBAC进行栓塞治疗。
