摘要
目的 分析咯血患者中起源于甲状颈干的异位支气管动脉解剖特点和栓塞治疗.方法 回顾性分析2020年1月至2023年7月在湖州市中心医院接受支气管动脉栓塞术(BAE)治疗的连续565例咯血患者临床资料.所有患者BAE前均接受多层螺旋CT血管造影(MDCTA)检查,其中519例BAE期间同时行锁骨下动脉及其分支DSA检查.对发现起源于甲状颈干支气管动脉的解剖、影像学表现及BAE情况进行初次描述.结果 21例患者中有22支起源于甲状颈干的异位支气管动脉.根据开口位置及血管走行,22支甲状颈干异位支气管动脉中13支(59.1％)为I型,4支(18.2％)为Ⅱ型,4支(18.2％)为Ⅲ型,1支(4.5％)为Ⅳ型.有5支(22.7％)异位支气管动脉与其他支气管动脉交通.所有异位支气管动脉均经BAE栓塞成功,术后均未发生严重并发症.结论 MDCTA联合锁骨下动脉及其分支DSA可显示起源于甲状颈干异位支气管动脉的解剖学特征.超选择性BAE栓塞此类支气管动脉安全有效.
Abstract
Objective To analyze the anatomical characteristics of ectopic bronchial artery originating from the thyrocervical trunk in patients with hemoptysis,and to discuss its embolization therapy.Methods The clinical data of 565 consecutive patients with hemoptysis,who underwent bronchial artery embolization(BAE)at the Huzhou Municipal Central Hospital of China between January 2020 and July 2023,were retrospectively analyzed.Before BAE,multi-slice spiral CT angiography was performed in all patients.In 519 patients DSA examination of the subclavian artery and its branches was simultaneously performed during the BAE procedure.The anatomical features and imaging manifestations of the ectopic bronchial artery originating from the thyrocervical trunk,as well as the BAE procedure were described.Results A total of 22 ectopic bronchial arteries originating from the thyrocervical trunk were detected in 21 patients.According to the origin position and running route,the ectopic bronchial arteries were classified into type Ⅰ(n=13,59.1％),type Ⅱ(n=4,18.2％),type Ⅲ(n=4,18.2％),and type Ⅳ(n=1,4.5％).Five ectopic bronchial arteries(22.7％)were communicated with other bronchial arteries.Successful BAE was accomplished for all ectopic bronchial arteries,and no serious postoperative complications occurred.Conclusion Multi-slice spiral CT angiography combined with DSA examination of the subclavian artery and its branches can clearly display the anatomical characteristics of the ectopic bronchial artery originating from the thyrocervical trunk.Super-selective embolization of the ectopic bronchial artery is clinically safe and effective.(J Intervent Radiol,2024,33:371-375)
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