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计算机断层扫描在罕见先天性心脏病诊断中的作用:主动脉弓中断。

The Role of Computed Tomography in The Diagnosis of Rare Congenital Heart Disease: Interrupted Aortic Arch.

机构信息

Department of Radiology, Kunming Yan'an Hospital; Key Laboratory of Cardiovascular Disease of Yunnan Province; Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming City, China.

Department of Pathology, Kunming Yan'an Hospital; Key Laboratory of Cardiovascular Disease of Yunnan Province; Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming City, China.

出版信息

Heart Surg Forum. 2022 Feb 28;25(1):E155-E162. doi: 10.1532/hsf.4539.

Abstract

Interrupted aortic arch (IAA) is a rare congenital anomaly of the aortic arch and an anatomical interruption of the lumen between the ascending and descending aorta. Computed tomography (CT) has become a reliable noninvasive diagnostic method for congenital IAA. The purpose of this study was to investigate the imaging features of IAA and improve the understanding and diagnosis of the disease. The imaging features and postoperative pathological data of 25 patients with IAA confirmed by dual-source computed tomography (DSCT) angiography were analyzed in this retrospective study. Among the 25 patients with IAA, 15 were type A, seven were type B, 0 were types C and D, and two were type E. The diameter of the pulmonary artery trunk in type A was larger than that in type B (P < 0.05). However, there were no significant differences between types A and B along the ascending aorta diameter, descending aorta, ascending aorta/descending aorta ratio, left pulmonary artery main trunk diameter, right pulmonary artery main trunk diameter, left pulmonary artery trunk/pulmonary artery trunk ratio, right pulmonary artery trunk/pulmonary artery trunk ratio, and left pulmonary artery trunk/right pulmonary artery trunk ratio. The imaging findings of IAA have typical and specific signs, and the types of IAA are not comprehensive. One type of patient identification can be added: Patients who are dissected between the left common carotid artery and left subclavian artery opening, and the descending aorta is circulated by the chest collaterals. Patients with a wide pulmonary artery in the IAA are usually type A patients. Patients with IAA after surgical repair require lifetime follow up, mainly to monitor left ventricular outflow tract obstruction and recurrent aortic coarctation. This study was approved by the Ethics Committee of Kunming Yan'an Hospital (Kunming City, Yunnan Province, China), and consent was waived because of the retrospective data collection.

摘要

主动脉弓中断(IAA)是一种罕见的主动脉弓先天性异常,是升主动脉和降主动脉之间管腔的解剖中断。计算机断层扫描(CT)已成为先天性 IAA 的可靠无创诊断方法。本研究旨在探讨 IAA 的影像学特征,提高对该病的认识和诊断水平。回顾性分析了 25 例经双源 CT(DSCT)血管造影证实的 IAA 患者的影像学特征和术后病理资料。25 例 IAA 患者中,A型 15 例,B 型 7 例,C 型和 D 型均为 0 例,E 型 2 例。A型患者的肺动脉干直径大于 B 型(P<0.05)。然而,在升主动脉直径、降主动脉、升主动脉/降主动脉比值、左肺动脉干直径、右肺动脉干直径、左肺动脉干/肺动脉干比值、右肺动脉干/肺动脉干比值和左肺动脉干/右肺动脉干比值方面,A型和 B 型之间没有显著差异。IAA 的影像学表现具有典型和特异性征象,但 IAA 类型并不全面。可以增加一种患者识别:在左颈总动脉和左锁骨下动脉开口之间被解剖的患者,降主动脉由胸侧支循环循环。IAA 中肺动脉较宽的患者通常为 A 型患者。接受 IAA 手术修复的患者需要终身随访,主要是监测左心室流出道梗阻和复发性主动脉缩窄。本研究经云南省昆明市延安医院伦理委员会批准(云南省昆明市),由于回顾性数据收集,豁免了同意。

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