The Value of Dual-Source CT in the Diagnosis of Anomalous Origin of Pulmonary Artery

Author(s):  
Yusen Feng ◽  
Pengcheng Ma ◽  
Lijuan Wang ◽  
Guifang Sun ◽  
Bin Liu ◽  
...  

Abstract Objective: This study is designed to explore the dual-source computed tomography (DSCT) imaging manifestations of the origin of three rare pulmonary artery abnormalities, and to improve the understanding and diagnosis of the disease.Methods: Collected 30 cases of patients diagnosed by DSCT with pulmonary artery abnormal origins, and retrospectively analyzed their imaging data and postoperative pathological data.Results: Among the 30 patients with abnormal pulmonary artery origin, 16 patients were with unilateral pulmonary artery absence (UAPA), 8 patients were with anomalous origin of unilateral pulmonary artery (AOPA), and 6 patients were left pulmonary artery suspension (LPAS). The diagnosis rate of DSCT is significantly higher than that of echocardiography. The results of DSCT imaging showed that the inner diameter of the ascending aorta, the aortic arch and the descending aorta of UAPA patients were significantly larger than those of LPAS patients (P<0.05). Compared with AOPA patients, the left pulmonary artery diameter, the ratio of the left main pulmonary artery diameter to the main pulmonary artery diameter, and ratio of the left main pulmonary artery diameter to the right main pulmonary artery diameter were significantly increased in UAPA patients (P<0.05). There was no significant difference in the ratio of the inner diameter of the ascending aorta to the descending aorta in patients with UAPA, AOPA and LPAS. Compared with UAPA patients, AOPA patients had no significant changes in the inner diameter of the main pulmonary artery, the inner diameter of the right main pulmonary artery, and the ratio of the inner diameter of the right main pulmonary artery to the main pulmonary artery.Conclusion: DSCT can be used to diagnose the origin of pulmonary artery abnormalities and distinguish its types.

2017 ◽  
Vol 24 (10) ◽  
pp. 1476-1479
Author(s):  
Faran Nasrullah ◽  
Rashid Mahmood ◽  
Shahlisa Hameedi

Objectives: To measure pulmonary artery and aortic calibers, and calculatingmain pulmonary artery to ascending aorta ratio in healthy children, to verify the adult ratio of1:1. Study Design: Observational study. Place and duration of study: Radiology Department,Combined Military Hospital, Peshawar from 15 July 2015 to 14 July 2016. Methodology:Chest CT cans of 283 healthy children, with no history or predisposing causes of pulmonaryhypertension, performed between July 2015 and July 2016, were retrospectively studied.Diameters of pulmonary artery and aorta were measured on CT chest, at the level of bifurcationof the main pulmonary artery, and the ratio of pulmonary artery to ascending aorta wascalculated. Results: The average diameter of the main pulmonary artery, right pulmonary arteryand left pulmonary artery were 19 mm, 12.1 mm and 12.2 mm respectively. The diameter of theascending aorta was determined to be 12.2 mm and descending aorta was 13.67 mm. Ratio ofthe main pulmonary artery to ascending aorta was 1.06, which was higher than the adult ration,usually taken as <0.9. Conclusion: The measurement criteria devised for early detection ofpulmonary hypertension have different set of values when considering pediatric population ascompared to adults. Main pulmonary artery to ascending aorta ratio is significantly higher inhealthy children of all ages as compared to adults. CT scan is an excellent minimally invasivemodality in evaluation of the mediastinal vasculature.


Author(s):  
Ali Kupeli ◽  
Ethem Unver ◽  
Gurkan Danisan ◽  
Eser Bulut

A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Material and Methods: Between October 2018 and June 2019, 62 patients with gastric wall fat halo sign and 97 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, ascending aorta, descending aorta, main pulmonary artery, right and left pulmonary artery, long and short cardiac axis and maximum transverse thorax diameters; and ascending, arcus, descending aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.125). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Conclusion: The gastric wall fat halo is the result of excessive fat accumulation and can be observed in overweight people, especially those with increased visceral fat tissue. Additionally, patients with a gastric wall fat halo have a higher cardiovascular risk because of increased vascular diameters, CTR, heart sizes and calcium scores.


2020 ◽  
Vol 13 (4) ◽  
pp. e234203
Author(s):  
Ken Nakamura ◽  
Kouan Orii ◽  
Takayuki Abe ◽  
Hirofumi Haida

Coronary aneurysm located just above the left main coronary artery (LMT) is rare and difficult to treat. How the aneurysm is accessed is very important as it determines the result of the surgery. A 70-year-old man with a large coronary aneurysm (40 mm in diameter) in the LMT underwent surgery to prevent its rupture; however, there was severe adhesion. Initially, dissection of the ascending aorta or the pulmonary artery seemed necessary to access the aneurysm; however, the process was possible with limited dissection between the ascending aorta and the pulmonary artery, and we succeeded in firmly closing the LMT site of entry.


2017 ◽  
Vol 5 (1) ◽  
pp. 232470961668462 ◽  
Author(s):  
Venkat Gangadharan ◽  
Kamesh Sivagnanam ◽  
Ghulam Murtaza ◽  
Michael Ponders ◽  
Otto Teixeira ◽  
...  

A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.


1992 ◽  
Vol 2 (2) ◽  
pp. 179-183
Author(s):  
Deborah M. Friedman ◽  
John Fernandes ◽  
Monika Rutkowski ◽  
Delores Danilowicz

AbstractA common systolic ejection murmur of the neonate has been attributed to physiologic peripheral pulmonic stenosis. We investigated this auscultatory finding using duplex pulsed Doppler. Three groups of normal fuliterm neonates less than one week old were studied—10 without murmurs, 10 with grade 1/6 murmurs and nine with at least grade 2/6 murmurs. We measured the anatomical size and peak flow velocities in the main pulmonary artery and left and right branches, the peak velocity in the right ventricular outflow tract, and the bifurcation angle. Flow gradients were calculated as 4 (Vmax)2 Groups were compared by t-tests. A loud peripheral pulmonic stenosis murmur was associated with increased pulmonary artery velocities, with left pulmonary artery velocity the most discriminating variable (1.3 ± 0.29 vs 0.94 ± 0.19 m/s; p ≤ 0.05). Although the peak gradient never exceeded 12 mmHg, there was an increased gradient in the loud murmur group (8.7 ± 2.6 vs 5.7 ± 2.2 mmHg; p ≤ 0.05) which may even be underestimated by the lack of angle correction. The left pulmonary artery diameter was also larger in the loud murmur group, but there were no other anatomic or volumetric flow differences between groups. The soft murmur group could not be separated from normals. We conclude that Doppler techniques can confirm the physiologic basis of peripheral pulmonic stenosis murmurs.


1995 ◽  
Vol 75 (17) ◽  
pp. 1294-1295 ◽  
Author(s):  
Hidemi Dodo ◽  
Juan C. Alejos ◽  
Joseph K. Perloff ◽  
Hillel Laks ◽  
Davis C. Drinkwater ◽  
...  

2021 ◽  
Vol 13 (3) ◽  
pp. 254-257
Author(s):  
İlker Mercan ◽  
Muhammet Akyuz ◽  
Onur Işık

Pulmonary arterial sling (PAS) is a relatively rare congenital anomaly in which left pulmonary artery branch originates abnormally from the right pulmonary artery, eventually resulting with respiratory symptoms, due to airway obstruction. In this report, we present a PAS in a neonate who showed progressive respiratory distress in the second week following delivery. At 25 days of age, the patient underwent total surgical correction of the anomaly, during which left pulmonary artery reimplantation to main pulmonary artery without the use of cardiopulmonary bypass was employed. Following an uneventful recovery, the patient was discharged eighteen days after surgery.


2020 ◽  
Vol 179 (3) ◽  
pp. 85-90
Author(s):  
A. P. Medvedev ◽  
S. A. Fedorov ◽  
V. V. Pichugin ◽  
A. L. Maksimov ◽  
M. B. Sukhova ◽  
...  

A rare case of catheter-induced infectious endocarditis of the right heart chambers complicated by embolism of the left pulmonary artery and its successful surgical treatment is presented. We performed the operation to remove a foreign body and vegetations from the superior vena cava and the right atrium, embolectomy from the left main branch of the pulmonary artery, chemical sanitation of the right chambers of the heart and pulmonary artery under extracorporeal circulation.


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