Türkvatan Aysel, Tola Hasan Tahsin, Kutlutürk Neşe, Güzeltaş Alper, Ergül Yakup
1 Department of Radiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul.
2 Department of Pediatric Cardiology, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Küçükçekmece, Istanbul.
World J Pediatr Congenit Heart Surg. 2017 Sep;8(5):590-596. doi: 10.1177/2150135117723903.
In this study, we aimed to determine lobar distribution, drainage sites, and associated cardiovascular anomalies of partial anomalous pulmonary venous connection in pediatric patients using low-dose multidetector computed tomographic angiography.
Sixty-one cases (27 female, mean age: 4.7 years) with partial anomalous pulmonary venous connection diagnosed by multidetector computed tomographic angiography were included in this study. In all patients, multidetector computed tomographic angiography examinations were performed using dual-source 256-slice scanner without sedation.
In 61 patients, 73 anomalous pulmonary veins were detected, 56 (77%) of them were right-sided and 17 (23%) were left-sided. Of 56 right-sided anomalous pulmonary veins in 49 patients, 38 (68%) drained into superior vena cava, eight (14%) into atriocaval junction, six (11%) into inferior vena cava, three (5%) into right atrium, and one (2%) into levoatriocardinal vein. Of 17 left-sided anomalous pulmonary veins in 12 patients, 16 (94%) drained into left innominate vein, and one (6%) into coronary sinus. Only seven (12%) patients had isolated partial anomalous pulmonary venous connection, whereas 54 (88%) patients had additional cardiovascular anomalies. The most common (66%) associated anomaly is atrial septal defect. The overall mean effective radiation dose was 1.12 mSv (range: 0.15-7.41 mSv), and it was 0.58 mSv (range: 0.15-0.73) in the patients younger than one-year old.
The presence and course of the anomalous pulmonary veins and associated cardiovascular anomalies can be reliably detected by dual-source 256-slice multidetector computed tomographic angiography with low radiation doses.
在本研究中,我们旨在使用低剂量多排螺旋计算机断层血管造影术确定儿科患者部分性肺静脉异位连接的肺叶分布、引流部位及相关心血管异常。
本研究纳入了61例经多排螺旋计算机断层血管造影术诊断为部分性肺静脉异位连接的病例(27例女性,平均年龄:4.7岁)。所有患者均使用双源256层扫描仪在未镇静的情况下进行多排螺旋计算机断层血管造影检查。
61例患者共检测到73条异常肺静脉,其中56条(77%)位于右侧,17条(23%)位于左侧。49例患者的56条右侧异常肺静脉中,38条(68%)引流至上腔静脉,8条(14%)引流至心房腔静脉连接处,6条(11%)引流至下腔静脉,3条(5%)引流至右心房,1条(2%)引流至左心房静脉。12例患者的17条左侧异常肺静脉中,16条(94%)引流至左无名静脉,1条(6%)引流至冠状窦。仅7例(12%)患者为孤立性部分性肺静脉异位连接,而54例(88%)患者伴有其他心血管异常。最常见的相关异常(66%)是房间隔缺损。总体平均有效辐射剂量为1.12 mSv(范围:0.15 - 7.41 mSv),1岁以下患者为0.58 mSv(范围:0.15 - 0.73)。
双源256层多排螺旋计算机断层血管造影术结合低辐射剂量能够可靠地检测出异常肺静脉的存在、走行及相关心血管异常。