Kauczor H U, Schwickert H C, Mayer E, Schweden F, Schild H H, Thelen M
Klinik für Radiologie, Johannes Gutenberg--Universität Mainz, Germany.
J Comput Assist Tomogr. 1994 Nov-Dec;18(6):855-61. doi: 10.1097/00004728-199411000-00002.
Computed tomography study of bronchial artery anatomy and evaluation of dilatation and tortuousity as indicators for pulmonary hypertension and surgical risk in patients with chronic thromboembolism were performed.
We retrospectively reviewed contrast-enhanced, thin section spiral CT scans of 39 patients undergoing pulmonary thromboendarterectomy. Findings were compared with mean pulmonary artery (PA) pressure in all, postoperative mortality in 33, and postoperative CT in 5 patients. Twenty patients without pulmonary hypertension served as controls.
In the pulmonary hypertension group, 50 bronchial arteries were observed in 30 of 39 patients. Their prevalence was significantly higher than in the control group (p < 0.0001). Their proximal diameter measured > or = 1.5 mm in 20 patients (51%); a tortuous course was found in 14 (36%). The correlation between total bronchial artery diameter and mean PA pressure was poor (r = 0.2). Patients with dilated bronchial arteries had a significantly lower risk for postoperative death than patients without (p < 0.05); positive predictive value was 100% and confidence interval 0.79-1.0. Despite normal postoperative PA pressures, bronchial arteries were still visible on follow-up studies.
The CT depiction of bronchial arteries, dilatation, and tortuousity provides indicators for chronic thromboembolic pulmonary hypertension. Its degree cannot be estimated. Dilated bronchial arteries are a significant predictor for survival of pulmonary thromboendarterectomy.
对慢性血栓栓塞症患者进行支气管动脉解剖的计算机断层扫描研究，并评估支气管动脉扩张和迂曲情况，以此作为肺动脉高压和手术风险的指标。
我们回顾性分析了39例行肺动脉血栓内膜剥脱术患者的增强薄层螺旋CT扫描结果。将结果与所有患者的平均肺动脉（PA）压力、33例患者的术后死亡率以及5例患者的术后CT进行比较。20例无肺动脉高压的患者作为对照组。
在肺动脉高压组中，39例患者中的30例观察到50条支气管动脉。其发生率显著高于对照组（p < 0.0001）。20例患者（51%）的支气管动脉近端直径测量值≥1.5 mm；14例（36%）发现有迂曲走行。支气管动脉总直径与平均PA压力之间的相关性较差（r = 0.2）。支气管动脉扩张的患者术后死亡风险显著低于未扩张的患者（p < 0.05）；阳性预测值为100%，置信区间为0.79 - 1.0。尽管术后PA压力正常，但在随访研究中仍可见支气管动脉。
CT对支气管动脉、扩张及迂曲情况的描绘可为慢性血栓栓塞性肺动脉高压提供指标。其程度无法估计。扩张的支气管动脉是肺动脉血栓内膜剥脱术生存的重要预测指标。
