迷走右锁骨下动脉影像表现及临床意义.docVIP

迷走右锁骨下动脉影像表现及临床意义 　　[摘要] 目的 探讨迷走右锁骨下动脉的CT、X线影像表现以及临床意义。 方法 回顾性分析34例迷走右锁骨下动脉病例的影像特征，同时详细了解其临床资料，并结合文献分析其临床意义。 结果 8例X线钡餐检查中，6例后前位及斜位显示食管于主动脉弓上缘有一左下向右上走行的螺旋形压迹，压迹光滑，食管局限性受压狭窄。所有34例CT扫描，在单一层面上，表现为食管旁或后软组织结节或条形影与主动脉弓相连续，密度与血管一致。连续层面观察或重建图像可见右锁骨下动脉自主动脉弓远侧内壁发出，绕过食道后方，向右上行走，可对食道造成不同程度压迫。大多数患者无症状，少部分食管、气管压迫严重者，特别是老年人，有吞咽困难或气短等症状。结论 CT检查易发现迷走右锁骨下动脉，并可以观察到对食道、气管的压迫程度，部分病例X线钡餐亦能发现，但仍需CT证实。正确认识迷走右锁骨下动脉影像表现对临床有重要意义。 　　[关键词] 迷走右锁骨下动脉；体层摄影术；X线计算机 　　[中图分类号] R445 [文献标识码] B [文章编号] 1673-9701（2014）27-0066-03 　　[Abstract] Objective To discuss the aberrant right subclavian artery in CT，X-ray imaging manifestations and clinical meanings. Methods Analyzed 34 aberrant right subclavian artery cases imaging features retrospectively and explicitly understand the clinical datas.At the same time，analyzed clinical meanings based on the documents. Results 8 cases in X-ray barium meal examination，6 cases showed that esophagus at aortic arch margo superior in back-front and oblique directions，runs a lower left to upper right spiral impressions，which was smooth，and the esophagus was locally cramped.CT in all 34 cases，in a single lay，aberrant subclavian artery was manifested as a soft-tissue nodule alongside or behind the esophagus，or a linear leaf，both connected to the aortic arch，and the density of them was equal to the vessels.Continuous lays and rebuilded images show that aberrant right subclavian artery originates from the distal inwall of aortic arch，and turns around the esophagus toward the upper right.It could impress the esophagus，but most of the patients had no symptoms.in a few esophagus and trachea seriously impressed cases，particularly in the aged，ocured the dysphagia and shortness of breath. Conclusion Aberrant right subclavian artery is easily found out in CT examinatoin，and observed the impression to the esophagus and trachea.in some cases，it also ocures in barium meal，but affirmed by CT. To correctly understand the aberrant right subclavian artery s imaging manifestions have a sig