【雙語(yǔ)病例】Pulmonary Artery Sling 肺動(dòng)脈吊帶

本期病例選自AuntMinnie.com,，轉(zhuǎn)自：雙語(yǔ)學(xué)影像

History and CT images

A 30-year-old man with chest pain and shortness of breath.

男,，30歲,，胸痛，呼吸困難,。

1.Alveolar consolidation（肺實(shí)變） is present.

 True

 False

2.Cardiomegaly （心影增大）is present.

 True

 False

3.Mediastinal adenopathy（縱膈淋巴結(jié)腫大） is present.

 True

 False

4.There is a tracheal abnormality（氣道異常）.

 True

 False

（請(qǐng)做出您的選擇,，答案見本文后方）

CT of the chest, PE protocol

5.What is the etiology of the tracheal narrowing?

 Aberrant vessel

 Adenopathy

 Esophageal narrowing

 Neurogenic tumor

 Pulmonary embolism

6.Which vessel is aberrant?

 Left inferior pulmonary vein

 Left pulmonary artery

 Left subclavian artery

 Left superior pulmonary vein

 Right pulmonary artery

正確答案

1. False

2. False

3. False

4. True
   

   There is indentation of the posterior trachea seen on the lateral film.

   側(cè)位像可見氣管后方壓跡。

5. Aberrant vessel

   There is aberrant course of one of the pictured vessels.

6. Left pulmonary artery

   The left pulmonary artery arises from the right pulmonary artery and courses between the trachea and esophagus

   左肺動(dòng)脈起源于右肺動(dòng)脈,，走行于氣管與食管之間,。

   
   

   
   

Findings and diagnosis

Findings

• PA and lateral chest x-ray: Indentation on the posterior aspect of the trachea on the lateral view.

  X線胸部正側(cè)位片：側(cè)位像可見氣管后方壓跡。

• Contrast-enhanced CT with attention to the pulmonary arteries: Aberrant left pulmonary artery arising from the right pulmonary artery with narrowing of the adjacent trachea and left mainstem bronchus, as well as mass effect on the anterior esophagus.

  CT增強(qiáng)掃描示左肺動(dòng)脈起源于右肺動(dòng)脈,，臨近主氣管及左側(cè)主支氣管狹窄,，食管受壓。
  

Differential diagnosis

• Pulmonary artery sling 肺動(dòng)脈吊帶

• Bronchogenic/foregut cyst 支氣管/前腸囊腫

• Tracheobronchomalacia 氣管支氣管軟化

• Bronchial atresia 支氣管閉鎖

Diagnosis:

Type I pulmonary artery sling

肺動(dòng)脈吊帶I型