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中华医学超声杂志(电子版) ›› 2019, Vol. 16 ›› Issue (01) : 43 -47. doi: 10.3877/cma.j.issn.1672-6448.2019.01.011

所属专题: 文献

外周血管超声影像学

大动脉炎肺动脉受累的常规超声与超声造影表现
李民1, 邓玉姣1, 朱剑2, 梁志欣3, 磨国鑫3, 马晓辉4, 唐杰1,   
  1. 1. 100853 北京,解放军总医院超声诊断科
    2. 100853 北京,解放军总医院风湿科
    3. 100853 北京,解放军总医院呼吸科
    4. 100853 北京,解放军总医院血管外科
  • 收稿日期:2018-02-08 出版日期:2019-01-01
  • 通信作者: 唐杰
  • 基金资助:
    国家自然科学基金(81327003)

Assessment of pulmonary artery involvement in Takayasu′s arteritis by conventional ultrsound and contrast-enhanced ultrasound

Min Li1, Yujiao Deng1, Jian Zhu2, Zhixin Liang3, Guoxin Mo3, Xiaohui Ma4, Jie Tang1,   

  1. 1. Department of Ultrasound, Chinese People′s Liberation Army General Hospital, Beijing 100853, China
    2. Department of Rheumatology, Chinese People′s Liberation Army General Hospital, Beijing 100853, China
    3. Department of Preumology, Chinese People′s Liberation Army General Hospital, Beijing 100853, China
    4. Department of Vascular Surgery, Chinese People′s Liberation Army General Hospital, Beijing 100853, China
  • Received:2018-02-08 Published:2019-01-01
  • Corresponding author: Jie Tang
引用本文:

李民, 邓玉姣, 朱剑, 梁志欣, 磨国鑫, 马晓辉, 唐杰. 大动脉炎肺动脉受累的常规超声与超声造影表现[J]. 中华医学超声杂志(电子版), 2019, 16(01): 43-47.

Min Li, Yujiao Deng, Jian Zhu, Zhixin Liang, Guoxin Mo, Xiaohui Ma, Jie Tang. Assessment of pulmonary artery involvement in Takayasu′s arteritis by conventional ultrsound and contrast-enhanced ultrasound[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2019, 16(01): 43-47.

目的

探讨大动脉炎肺动脉受累的常规超声及超声造影特点及在疾病诊断中的价值。

方法

回顾分析5例大动脉炎肺动脉受累患者的超声心动图、外周血管超声及心脏和外周血管超声造影的表现。

结果

5例患者中主要的常规超声表现:三尖瓣反流(4/5)、肺动脉瓣反流(2/5)、肺动脉高压(3/5)、左或右肺动脉主干管腔细小(3/5)、左或右肺动脉主干管壁增厚回声减低(3/5),肺动脉以外的外周动脉受累(5/5);超声造影表现:左或右肺动脉主干管腔呈低或无增强(4/4),外周动脉增厚管壁明显增强或少量增强(4/5),无增强(1/5)。

结论

大动脉炎肺动脉受累的超声表现有其特征性,肺动脉的常规超声和超声造影检查结合临床表现及外周动脉的病变情况将有助于明确诊断。

Objective

To investigate the characteristics of pulmonary artery involvement in Takayasu′s arteritis by conventional ultrasound and contrast-enhanced ultrasound and its value in the diagnosis of the disease.

Methods

The findings of echocardiography, peripheral vascular ultrasound, and contrast enhanced ultrasound of the heart and peripheral vessels were reviewed and analyzed in 5 patients with pulmonary artery involvement in Takayasu′s arteritis.

Results

The main features of conventional ultrasound in 5 patients were as follows: tricuspid regurgitation (4/5), pulmonary valvular regurgitation (2/5), pulmonary arterial hypertension (3/5), the diameter of the left or right pulmonary artery was decreased (3/5), the wall of the left or right pulmonary artery was thickened and the echogenicities were decreased (3/5), the peripheral vessels outside the pulmonary artery were invaded (5/5). The main features of contrast-enhanced ultrasound in 5 patients were as follows: the diameter of the left or right pulmonary arteries showed low or no enhancement (4/4), thickened vascular walls were markedly or slightly enhanced (4/5), thickened vascular walls were not enhanced (1/5).

Conclusions

The ultrasonic manifestations of pulmonary artery involvement in Takayasu′s arteritis have some characteristics. Conventional plus and contrast-enhanced ultrasound combined with clinical manifestations and peripheral vascular findings will be helpful in the diagnosis of pulmonary arteries involvement in Takayasu′s arteritis.

图3 肺动脉主干及其分支的灰阶超声图像。白色箭头示左肺动脉主干管腔变细,黄色箭头示左肺动脉主干管壁增厚、回声减低
表1 5例大动脉炎患者肺动脉受累的临床特征
图4 大动脉炎的CCA病变部位的灰阶超声图像,白箭头示CCA增厚管壁
表2 5例大动脉炎患者肺动脉受累的常规超声及超声造影表现
图5 肺动脉主干及其分支的超声造影图像。白色箭头示左肺动脉主干管腔变细,呈低增强
图6 大动脉炎的CCA病变部位的超声造影图像。白色箭头示CCA增厚管壁可见少量点状增强
1
Katsuyama T, Sada KE, Makino H. Current concept and epidemiology of systemic vasculitides [J]. Allergol Int, 2014, 63(4): 505-513.
2
Richards BL, March L, Gabriel SE. Epidemiology of large-vessel vasculidities [J]. Best Pract Res Clin Rheumatol, 2010, 24(6): 871-883.
3
Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis [J]. Arthritis Rheum, 1990, 33(8): 1129-1134.
4
Schinkel AF, van den Oord SC, van der Steen AF, et al. Utility of contrast-enhanced ultrasound for the assessment of the carotid artery wall in patients with Takayasu or giant cell arteritis [J]. Eur Heart J Cardiovasc Imaging, 2014, 15(5): 541-546.
5
栗占国, 唐福林, 主译. 凯利风湿病学 [M]. 8版, 北京: 北京大学医学出版社, 2011: 1506-1507.
6
汪忠镐, 主编. 汪忠镐血管外科学 [M]. 杭州: 浙江科学技术出版社, 2010: 729.
7
杨丽睿, 张慧敏, 蒋雄京, 等. 566例大动脉炎患者的临床特点及预后 [J].中国循环杂志, 2015, 30(9): 849-853.
8
刘亚欣, 高凌根, 李琳, 等. 大动脉炎累及肺动脉的临床特征、治疗及预后分析 [J]. 中国循环杂志, 2013, 28(3): 195-198.
9
孙腾, 张慧敏, 马文君, 等. 大动脉炎单纯累及肺动脉一例 [J]. 中国循环杂志, 2012, 27(6): 405.
10
马秀娥, 程显声. 临床病理讨论—胸闷、气短, 双下肢皮肤红斑、溃疡、浮肿 [J]. 中国循环杂志, 1988, 3(1): 290-291.
11
Enrico A, Francesco M, Patrizia P, et al. Non-invasive imaging of vascular inflammation [J]. Front immunol, 2014, 5(8): 399-414.
12
Papa M, De Cobelli F, Baldissera E, et al. Takayasu arteritis: intravascular contrast medium for MR angiography in the evaluation of disease activity [J]. AJR Am J Roentgenol, 2012, 198(3): W279-W284.
13
Soussan M, Nicolas P, Schramm C, et al. Management of Large-Vessel Vasculitis With FDG-PET [J]. Medicine, 2015, 94(14): e622.
14
Fuchs M, Briel M, Daikeler T, et al. The impact of 18F-FDG PET on the management of patients with suspected large vessel vasculitis [J]. Eur J Nucl Med Mol Imaging, 2012, 39(2): 344-353.
15
丁允琪, 刘升云, 张欣, 等. 18F-FDG PET/CT在大动脉炎早期诊断及病情评估中的应用研究 [J]. 医药论坛杂志, 2014, 35(1): 134-135.
16
Raninen RO, Kupari MM, Pamilo MS, et al. Arterial wall thickness measurements by B mode ultrasonography in patients with Takayasu′s arteritis [J]. Ann Rheum Dis, 1996, 55(7): 461-465.
17
Bacon P, Direskeneli H. Quantifying disease involvement in Takayasu′s arteritis [J]. Rheumatology (Oxford), 2014, 53(9): 1535-1536.
18
戴晓敏, 董智慧, 陈盛, 等. 大动脉炎诊断及活动性评价中国专家调查 [J]. 复旦学报(医学版), 2017, 44(2): 127-133.
19
Choi HK, Kim HK, Shin HS, et al. Total Occlusion of Right Main Pulmonary artery in a Patient with Takayasu′s Arteritis and Severe Pulmonary Hypertension [J]. J Cardiovasc Ultrasound, 2012, 20(4): 189-192.
20
Jin SA, Lee JH, Park JH, et al. Endovascular Treatment in a Patient with Left Main Coronary and Pulmonary Arterial Stenoses as Initial Manifestation of Takayasu′s Arteritis [J]. Heart Lung Circ, 2015, 24(2): e26-e30.
21
Jiang W, Yang Y, Lv X, et al. J.Echocardiographic characteristics of pulmonary artery involvement in Takayasu arteritis [J]. Echocardiography, 2017, 34(3): 340-347.
22
Giordana P, Baque´-Juston MC, Jeandel PY, et al. Contrast-enhanced ultrasound of carotid artery wall in Takayasu disease: first evidence of application in diagnosis and monitoring of response to treatment [J]. Circulation, 2011, 124(2): 245-257.
23
Magnoni M, Dagna L, Coli S, et al. Assessment of Takayasu arteritis activity by carotid contrast-enhanced ultrasound [J]. Circ Cardiovasc Imaging, 2011, 4(2): e1-e2.
24
李民, 安力春, 朱剑, 等. 超声造影在多发性大动脉炎活动性判断中的价值 [J/CD]. 中华医学超声杂志(电子版), 2016, 13(9): 677-682.
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