Dillon E H, Camputaro C
Centrum Radiodiagnostiek, Academisch Ziekenhuis Utrecht, The Netherlands.
AJR Am J Roentgenol. 1993 Feb;160(2):375-9. doi: 10.2214/ajr.160.2.8424355.
Partial anomalous pulmonary venous drainage of the left upper lobe and duplication of the superior vena cava have similar appearances on CT scans. The purpose of this study was to review their appearances and provide guidelines for differentiating between them.
A review of the CT reports for the preceding 4 years disclosed seven patients whose original diagnosis was duplication of the superior vena cava and one patient whose diagnosis was partial anomalous pulmonary venous drainage of the left upper lobe. The 14 CT examinations of these eight patients were reviewed in order to observe the CT findings in each anomaly.
In only five of the seven patients whose original diagnosis was duplication of the superior vena cava were CT findings compatible with that diagnosis. In the other two, CT findings were compatible with partial anomalous pulmonary venous drainage of the left upper lobe, as they were in the one patient with that as his original diagnosis. Two CT findings allow consistent differentiation. In duplication of the superior vena cava, two vessels can be seen anterior to the left main bronchus, whereas no vessels are present in this location in partial anomalous pulmonary venous drainage of the left upper lobe. Additionally, careful inspection reveals that the intraparenchymal veins in the left upper lobe drain to the normally positioned left superior pulmonary vein in duplication of the superior vena cava, whereas they drain to the anomalous vessel in partial anomalous pulmonary venous drainage of the left upper lobe.
Careful analysis of the CT scans with particular attention to these two features allows differentiation between partial anomalous pulmonary venous drainage of the left upper lobe and duplication of the superior vena cava.
左上叶部分性肺静脉异位引流和上腔静脉重复畸形在CT扫描上有相似表现。本研究的目的是回顾它们的表现，并提供鉴别两者的指南。
回顾前4年的CT报告，发现7例最初诊断为上腔静脉重复畸形的患者和1例诊断为左上叶部分性肺静脉异位引流的患者。对这8例患者的14次CT检查进行回顾，以观察每种异常的CT表现。
最初诊断为上腔静脉重复畸形的7例患者中，只有5例的CT表现与该诊断相符。另外2例以及最初诊断为左上叶部分性肺静脉异位引流的那例患者，其CT表现与左上叶部分性肺静脉异位引流相符。有两个CT表现可进行一致性鉴别。在上腔静脉重复畸形中，可在左主支气管前方看到两条血管，而在左上叶部分性肺静脉异位引流中该位置无血管。此外，仔细观察发现，上腔静脉重复畸形时左上叶实质内静脉引流至正常位置的左上肺静脉，而在左上叶部分性肺静脉异位引流中它们引流至异常血管。
仔细分析CT扫描并特别关注这两个特征可鉴别左上叶部分性肺静脉异位引流和上腔静脉重复畸形。
