肺动脉假性动脉瘤栓塞术中CT对脊髓动脉的可视化
Visualization of the Spinal Artery by CT During Embolization for Pulmonary Artery Pseudoaneurysm.
作者信息
Maki Hiroyuki, Shimohira Masashi, Hashizume Takuya, Kawai Tatsuya, Nakagawa Motoo, Ozawa Yoshiyuki, Sakurai Keita, Shibamoto Yuta
机构信息
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
出版信息
Pol J Radiol. 2016 Aug 15;81:382-5. doi: 10.12659/PJR.897975. eCollection 2016.
BACKGROUND
Spinal artery ischemia is a rare but serious complication of embolization for treatment of hemoptysis. When the spinal artery is visualized at angiography, embolization should not be performed. However, it has been reported that spinal artery feeders are not visible on angiography in patients with developing spinal infarction.
CASE REPORT
A 70-year-old man with a history of pulmonary aspergillosis had hemoptysis and underwent contrast-enhanced CT, revealing a pulmonary artery pseudoaneurysm (PAP) in the left upper lobe. Systemic angiography from the fifth left intercostal artery showed the PAP at the distal site, but the access route to the PAP was very tortuous and long. Although the spinal branch could not be observed with that angiography, CT during angiography was performed, and it visualized the posterior spinal artery obviously. Thus, the artery distal and proximal to the PAP was then successfully coil-embolized from the pulmonary artery.
CONCLUSIONS
CT during angiography may be useful to confirm the presence of the spinal artery for treatment of hemoptysis by embolization.
背景
脊髓动脉缺血是咯血栓塞治疗中一种罕见但严重的并发症。当脊髓动脉在血管造影中显影时，不应进行栓塞。然而，有报道称，在发生脊髓梗死的患者中，脊髓动脉供血支在血管造影中不可见。
病例报告
一名有肺曲霉病病史的70岁男性出现咯血，接受了增强CT检查，发现左上叶有肺动脉假性动脉瘤（PAP）。从左第五肋间动脉进行的全身血管造影显示远端部位有PAP，但通往PAP的通路非常迂曲且长。尽管该血管造影未观察到脊髓分支，但在血管造影期间进行了CT检查，明显显示出脊髓后动脉。因此，随后成功地从肺动脉对PAP远端和近端的动脉进行了弹簧圈栓塞。
结论
血管造影期间的CT检查对于确认脊髓动脉的存在以进行咯血栓塞治疗可能是有用的。
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