Huhmann W, Kunitsch G, Dalichau H
Dtsch Med Wochenschr. 1976 Oct 8;101(41):1477-81. doi: 10.1055/s-0028-1104294.
Chest X-rays were analysed in 22 male and 16 female patients (mean age 30.7 years) with coarctation of the aorta. The results were correlated with angiography, haemodynamic pressures and operative findings. The left subclavian artery was prominent in 33 cases, signs indicating a collateral circulation (rib notching, internal mammary artery) were present in 26 cases. In addition there were changes of cardiac and aortic configuration. The least reliable sign was constriction of the aorta due to the stenosis itself. Frequent combinations of X-ray signs were dilatation of the left subclavian artery and a collateral circulation, in addition to signs of increased pressure (n = 25). Less frequently (n = 8) only a dilated subclavian artery and signs of increased pressure were found. The prominence of the subclavian artery was particularly marked in systolic pressure gradients through the stenosis of greater than 40 mm Hg, and the formation of a collateral circulation when average aortic pressure differences above and below the stenosis were less than 40 mm Hg. Collaterals were to be found most frequently with a correlation of 2:1 of the systolic gradient to the mean pressure gradient delta Ps/delta Pm. A very good correlation existed comparing X-ray signs with findings at operation. The diagnosis of coarctation of the aorta can thus be made with sufficient certainty from the plain chest X-ray.
对22例男性和16例女性（平均年龄30.7岁）主动脉缩窄患者的胸部X光片进行了分析。结果与血管造影、血流动力学压力及手术所见进行了相关性分析。33例患者左锁骨下动脉突出，26例有侧支循环征象（肋骨切迹、胸廓内动脉）。此外，心脏和主动脉形态也有改变。最不可靠的征象是由狭窄本身导致的主动脉缩窄。X光征象的常见组合是左锁骨下动脉扩张和侧支循环，以及压力升高的征象（n = 25）。较少见的情况（n = 8）是仅发现锁骨下动脉扩张和压力升高的征象。当通过狭窄处的收缩压梯度大于40 mmHg时，锁骨下动脉突出尤为明显；当狭窄上下平均主动脉压差小于40 mmHg时，会形成侧支循环。侧支循环最常出现在收缩期梯度与平均压力梯度的比值为2:1（ΔPs/ΔPm）时。X光征象与手术所见之间存在非常好的相关性。因此，通过胸部平片可以足够确定地做出主动脉缩窄的诊断。
