Wang Chi, Wu Rongchang, Wang Zihan, Ma Shuai, Yuan Xinyu, Yan Yuchun, Peng Yun
Capital Institute of Pediatrics, Department of Radiology, Beijing, China.
Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Department of Radiology, Beijing, China.
Diagn Interv Radiol. 2025 Apr 28;31(3):280-284. doi: 10.4274/dir.2024.242908. Epub 2024 Oct 21.
By retrospectively studying the chest computed tomography (CT) data of children with bronchial artery (BA)-pulmonary artery fistula, this study summarizes the characteristic imaging features of the disease and provides imaging support for the diagnosis and clinical treatment of these children.
Digital subtraction angiography and CT angiography data were collected from 74 children with pulmonary hemorrhage following BA embolization. Bronchial-pulmonary shunt was present in 30 cases.
Of the 74 children with pulmonary hemorrhage in this study, seven exhibited signs of consolidation in the middle lobe of the right lung, and bronchial-pulmonary shunt existed in all of them. A total of 30 children with BA-pulmonary artery shunt (PAS) had BA tortuosity and thickening. Regarding primary BA-PAS, the middle lobe and lower lobe of the right lung were involved in 94.1% (16) of the children. Those with a fistula located in the middle lobe of the right lung accounted for 58.8% (10 cases), of which 40.0% (four cases) presented consolidation. In this study, 41.2% (seven) of the children with primary BA-PAS exhibited no abnormal changes on chest CT, and 58.8% (10 cases) exhibited abnormal changes in the unilateral lung.
For children with pulmonary hemorrhage who have consolidation in the right middle lobe, the formation of BA-PAS should be anticipated. The possibility of primary BA-PAS should not be disregarded in children with pulmonary hemorrhage with tortuosity and dilation of BAs, despite no apparent abnormalities on lung CT, or ground-glass density or consolidation on only one side.
The chest CT of patients with pulmonary hemorrhage showed consolidation of the right middle lobe of the lung, which was highly likely to indicate BA-PAS.
通过回顾性研究支气管动脉（BA）-肺动脉瘘患儿的胸部计算机断层扫描（CT）数据，总结该疾病的特征性影像表现，为这些患儿的诊断及临床治疗提供影像支持。
收集74例BA栓塞术后发生肺出血患儿的数字减影血管造影及CT血管造影数据。其中30例存在支气管-肺分流。
本研究中74例肺出血患儿中，7例右肺中叶出现实变征象，且均存在支气管-肺分流。30例BA-肺动脉分流（PAS）患儿中，BA迂曲增粗。对于原发性BA-PAS，94.1%（16例）患儿累及右肺中叶及下叶。瘘位于右肺中叶者占58.8%（10例），其中40.0%（4例）出现实变。本研究中，原发性BA-PAS患儿41.2%（7例）胸部CT无异常改变，58.8%（10例）单侧肺出现异常改变。
对于右肺中叶实变的肺出血患儿，应考虑BA-PAS的形成。对于BA迂曲扩张的肺出血患儿，即使肺部CT无明显异常或仅一侧出现磨玻璃密度或实变，也不应忽视原发性BA-PAS的可能性。
肺出血患者的胸部CT显示右肺中叶实变，极有可能提示BA-PAS。
