Adey C K, Soto B, Shin M S
Radiology. 1986 Oct;161(1):113-7. doi: 10.1148/radiology.161.1.3763853.
Seven patients with congenital pulmonary venous stenosis were retrospectively evaluated. Chest radiographs and pulmonary angiograms were interpreted without knowledge of anatomic findings, and results were correlated with autopsy data. Bilateral foci of stenosis of varying severity were found in all patients but occurred with greater frequency and severity in the left-sided pulmonary veins. Chest radiographic findings revealed asymmetric pulmonary vascularity in all patients. Shunt vascularity was seen in three right upper zones and three right lower zones but was not observed in any of the left lung zones. In seven patients angiograms revealed asymmetry in the size and number of pulmonary arterial branches. Arterial vascularity was increased in two right upper zones and four right lower zones but was not increased in any of the left lung zones. Pulmonary veins from 22 zones were visualized. Pulmonary venous opacification was delayed, asymmetric, and asynchronous in the majority. Venoatrial stenosis was seen in veins from 18 zones. Congenital pulmonary vein stenosis can be suspected based on chest radiographic findings of asymmetry of pulmonary vascularity between both lungs as well as regional discrepancies in the vascularity within each lung. Pulmonary angiography can support the diagnosis.
对7例先天性肺静脉狭窄患者进行了回顾性评估。在不了解解剖学结果的情况下解读胸部X线片和肺血管造影，并将结果与尸检数据进行关联。所有患者均发现双侧不同程度的狭窄病灶，但左侧肺静脉的狭窄频率和严重程度更高。胸部X线片表现显示所有患者均有肺血管不对称。分流血管在右上三个区域和右下三个区域可见，但在左肺任何区域均未观察到。7例患者的血管造影显示肺动脉分支的大小和数量不对称。右上两个区域和右下四个区域的动脉血管增多，但左肺任何区域均未增多。观察了22个区域的肺静脉。大多数情况下，肺静脉显影延迟、不对称且不同步。18个区域的静脉可见腔静脉狭窄。根据两肺之间肺血管不对称以及每侧肺内血管分布的区域差异等胸部X线片表现，可怀疑先天性肺静脉狭窄。肺血管造影可支持诊断。
