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左下叶肺动脉夹层的罕见表现

Rare Presentation of Left Lower Lobe Pulmonary Artery Dissection.

作者信息

Hako René, Fedačko Ján, Tóth Štefan, Morochovič Radoslav, Kristian Pavol, Pekárová Tímea, Tuomainen Petri, Pella Daniel

机构信息

Department of Radiology, General Hospital Košice, 9 Masarykova, 040 01 Košice, Slovakia.

First Department of Internal Medicine, Louis Pasteur University Hospital, Trieda SNP 1, 041 90 Košice, Slovakia.

出版信息

Case Rep Med. 2017;2017:2760535. doi: 10.1155/2017/2760535. Epub 2017 Jan 5.

Abstract

. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. . We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR) images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. . To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension.

摘要

以慢性肺动脉高压为主要病因的肺动脉夹层是一种非常罕见但危及生命的疾病。在大多数情况下,主要肺动脉干是受累部位,其分支通常未受累。节段性或叶性肺动脉夹层极为罕见。我们报告一例70岁男性左下叶肺动脉夹层的独特病例,已确诊为慢性肺动脉高压。为确诊夹层,采用了MDCT肺动脉造影。生成了矢状面、冠状面、斜矢状面和曲面投影的多平面重建(MPR)图像。本病例报告展示了罕见的与慢性肺动脉高压相关的慢性左叶肺动脉夹层在局部肺动脉钙化部位的形态学CT特征。CT肺动脉造影排除了血栓栓塞迹象以及潜在的运动或血流伪影。据我们所知,尚未有下叶肺动脉夹层伴瓣叶钙化的病例报道。胸部CT成像作为关键的诊断工具,能够检测肺动脉树内的内膜瓣和假腔,在持续性肺动脉高压罕见并发症的鉴别诊断中具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ad/5244010/b9cc5761fc36/CRIM2017-2760535.001.jpg

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