摘要
目的 探讨单纯型和复合型先天性主动脉缩窄(COA) CT表现的差异及其临床意义.方法 回顾性分析28例COA患者的CT表现,比较单纯型(n=12))和复合型(n =16)COA的缩窄范围、受累部位、狭窄程度、合并变异血管、心血管畸形和侧支循环的差异并行统计学检验.结果 28例中,病变范围:局限性COA 17例(60.7％),长段性COA 11例(39.3％).病变部位:单纯型COA发生于左锁骨下动脉远端8例(28.6％)、胸主动脉3例(10.7％)、左颈总动脉-左锁骨下动脉1例(3.6％),复合型COA发生于升主动及主动脉弓6例(21.4％)、左颈总及左锁骨下动脉之间3例(10.7％)、左锁骨下动脉远端5例(17.9％)、胸主动脉2例(7.1％).狭窄程度:单纯型为80.3±10.4％,复合型为68.5±7.3％(P=0.02).合并血管变异:单纯型3例(10.7％),复合型7例(/25％) (P =0.000).合并心血管畸形:单纯型少于复合型((P＜0.01)).伴侧支循环:单纯型12例(100％),复合型无侧支循环.结论 单纯型和复合型COA的CT表现各有特征性,明确二者的差异有助于COA的早期诊断.
Abstract
Objective To investigate CT findings of simple and complex congenital coarctation of the aorta (CoA),and to discuss its clinical significance.Methods A total of 28 patients with CoA,including simple type (n =12) and complex type (n =16),were enrolled in this study.CT manifestations,focusing on the extent of coarctation,involved area,degree of stenosis,coexisting cardio-vascular abnormalities and collateral circulations,were analyzed,and the statistical analysis was conducted.Results Of the 28 patients,the lesion was localized in 17 (60.7％) and long segmental in 11 (39.3％).In simple CoA,the lesion was located at the distal end of the left subclavian artery in 8 cases (28.6％),at the thoracic aorta in 3 cases (10.7％) and at the left common carotid-subclavian artery in one case (3.6％).In complex CoA,the lesion was located at ascending aorta or aortic arch in 6 cases (21.4％),at the left common carotid-subclavian artery in 3 case (10.7％),at the distal end of the left subclavian artery in 5 cases (17.9％) and at the thoracic aorta in 2 cases (7.1％).The degree of stenosis in the simple type and in the complex type was 80.3 ± 10.4％ and 68.5 ± 7.3 ％ respectively,the difference was statistically significant (P =0.02).Associated vascular variations were observed in 3 cases (10.7％) in simple type and in 7 cases (25％) in complex type,and the difference was statistically significant (P =0.000).Coexisting cardio-vascular abnormality in simple type was less seen than that in complex type (P ＜ 0.01).Collateral circulation was seen in all 12 cases of simple type,nevertheless no circulation was observed in the cases of complex type.Conclusion Simple type and complex type of CoA have their own CT features,the understanding of the characteristics of each type can help make early diagnosis.
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