Ledda Gianluca, Caldin Marco, Mezzalira Giorgia, Bertolini Giovanna
'San Marco' Private Veterinary Clinic, via Sorio 114/c, 35141, Padua, Italy.
'San Marco' Private Veterinary Laboratory, via Sorio 114/c, 35141, Padua, Italy.
Vet Radiol Ultrasound. 2015 Jul-Aug;56(4):347-58. doi: 10.1111/vru.12247. Epub 2015 Mar 9.
Anomalies involving arterial branches in the lungs are one of the causes of hemoptysis in humans and dogs. Congenital and acquired patterns of bronchoesophageal artery hypertrophy have been reported in humans based on CT characteristics. The purpose of this retrospective study was to describe clinical, echocardiographic, and multidetector computed tomography features of bronchoesophageal artery hypertrophy and systemic-to-pulmonary arterial communications in a sample of 14 dogs. Two main vascular patterns were identified in dogs that resembled congenital and acquired conditions reported in humans. Pattern 1 appeared as an aberrant origin of the right bronchoesophageal artery, normal origin of the left one, and enlargement of both the bronchial and esophageal branches that formed a dense network terminating in a pulmonary artery through an orifice. Pattern 2 appeared as a normal origin of both right and left bronchoesophageal arteries, with an enlarged and tortuous course along the bronchi to the periphery of the lung, where they communicated with subsegmental pulmonary arteries. Dogs having Pattern 1 also had paraesophageal and esophageal varices, with the latter being confirmed by videoendoscopy examination. Authors conclude that dogs with Pattern 1 should be differentiated from dogs with other congenital vascular systemic-to-pulmonary connections. Dogs having Pattern 2 should be evaluated for underlying pleural or pulmonary diseases. Bronchoesophageal artery hypertrophy can be accompanied by esophageal venous engorgement and should be included in the differential diagnosis for esophageal and paraesophageal varices in dogs.
涉及肺部动脉分支的异常是人类和犬咯血的原因之一。基于CT特征,人类已报告了支气管食管动脉肥大的先天性和后天性模式。这项回顾性研究的目的是描述14只犬样本中支气管食管动脉肥大和体循环至肺循环动脉分流的临床、超声心动图及多排螺旋计算机断层扫描特征。在犬中识别出两种主要血管模式,类似于人类报告的先天性和后天性情况。模式1表现为右支气管食管动脉起源异常,左支气管食管动脉起源正常,支气管和食管分支均增粗,形成一个致密网络,通过一个孔口终止于肺动脉。模式2表现为左右支气管食管动脉起源均正常,沿支气管走行增粗且迂曲,至肺周边与亚段肺动脉相通。具有模式1的犬还伴有食管旁和食管静脉曲张,后者经视频内镜检查得以证实。作者得出结论,模式1的犬应与其他先天性体循环至肺循环血管连接的犬相鉴别。具有模式2的犬应评估是否存在潜在的胸膜或肺部疾病。支气管食管动脉肥大可伴有食管静脉充血,应纳入犬食管和食管旁静脉曲张的鉴别诊断。