| Objective:Through the64-slice spiral CT and reconstruction techniques to observethe imaging findings of central airway stenosis which caused by vascularmalformation,we research the relationship between the cardiovascularmalformation and central airway stenosis,explore the general trend aboutcardiovascular malformation and airway stenosis, in order to improve thedetection rate of lesions.there was of great value for the diagnosis ofdisease clinical assessment,the choice of treatment efficacy and prognosis.Methods:A total of105case who were confirmed vascular malformation with ftracheal stenosis in Chongqing Medical University Affliliated Children’shospital,all of the children underwent ultrasound and chest CT,somepatients also underwent fiber bronchoscope and angiography. retrospectiveanalysis the images of64layers spiral CT images post-processing,According to the position of tracheal stenosis segment, Tracheal bronchuscan be divided into3sections,the first segment is from tracheal starting to aortic arch level,such as the segment tracheal stenosis occurred calledtype I; Aortic arch plane to tracheal bifurcation between tracheal segmentcalled the second section,in which type of tracheal stenosis occurred calledtype II; The segment3refers to the tracheal bifurcation level,contain bothsides of the main bronchus and right middle period of bronchial stenosis,That is called type III,besides, The left main bronchial stenosis is calledtype III1, and right main bronchial stenosis is called type III2. According tothe above standard of each segment tracheal stenosis cases and lead to thecorresponding tracheal stenosis vascular malformation type, on the basis ofcotton and Grundfast narrow length staging of tracheal stenosis degreerespectively,Then classified according to different types of vascularmalformation,caused by summarizing the distribution of tracheal stenosisin place To explore the relationship between different vascularmalformation and comorbid airway stenosis.Results:105cases of heart in children with concurrent airway stenosis, vascularmalformation, male52cases, female53cases, all children were classifiedaccording to the narrow parts, including11cases with tracheal stenosis intwo or more, including20cases (19.05%) of type I,59patients (56.19%) oftype II,38cases (36.19%) of type III.Type I contain Anonymous artery compression syndrome was95.00%(19/20),High aortic arch was5.00%(5/20). Type II contain Double aortic arch was20.34%（12/59）, Right aorticarch was16.95%（10/59,right aortic arch with The vagus left subclavianartery was16.95%（10/59）, arcus aortae oppression was18.64%（11/59）,pulmonary artery sling was18.64%（11/59）, transposition of the greatarteries was3.39%(2/59), Descending aorta oppression was1.69%（1/59）,Abnormal collateral oppression was1.69%（1/59）.type III contain32cases (30.48%) of type I,6cases (5.71%) of type II.type I contain right pulmonary artery oppression was34.38%（11/32）,anomalous pulmonary venous connection was15.63%（5/32），transpositionof the great arteries was15.63%（5/32），Descending aorta oppression was6.25%（2/32）, pulmonary artery sling was6.25%（2/32）, Double aortic archwas6.25%（2/32），pulmonary venous oppression was6.25%（2/32）,Right aortic arch was3.13%（1/32）, arcus aortae oppression was3.13%（1/32），right aortic arch with patent ductus arteriosus was3.13%（1/32）.type II contain right pulmonary artery oppression was50.00%（3/6）,pulmonary artery sling was33.33%（2/6），Right aortic arch was16.67%（1/6）.According to the method of cotton and grundfast tracheal bronchialstenosis degree above staging,wo can get: The average degree of stenosisof type I was24.24%±9.24%，The average degree of stenosis of type IIwas38.43%±16.05%，Statistical significance was found between the two（P＜0.05）.The length of tracheal stenosis in type I was8.58mm± 2.20mm, in type II was7.39mm±2.27mm,in type III was10.74mm±4.49mm. With no statistical significance Between type I and type II（P＞0.05）, Statistical significance was found between type I and type III（P＜0.05）, type II and type III（P＜0.05）.All cases according to the classification of vascular malformation,there are6cases in105cases of children with two different parts oftracheal stenosis caused by vascular malformation。The vascular ring was51.45%（54/105）, The abnormalities of the thoracic aorta was26.67%（28/105）, The abnormalities of the Pulmonary vascular was15.25%（9/105）,other malformation was12.38%（13/105）.54cases of vascularring malformation contain: The tracheal stenosis of type II was62.96%（34/54）,28cases of the abnormalities of the thoracic aorta cotain78.57%（22/28）tracheal stenosis of type II. The average degree of stenosis oftype II Which caused by vascular ring was40.55%±17.97%，The averagedegree of stenosis of type II Which caused by abnormalities of the thoracicaorta was33.91%±12.77%，Statistical significance was found between thetwo（P＜0.05）.The tracheal stenosis caused by the abnormalities of thethoracic aorta were type I and type II, Respectively was40.55%±17.97%、25.45%±8.32%. Statistical significance was found between thetwo（P＜0.05）.Conclusion:1.Heart always send the central airway stenosis vascular malformation, Mainly exist in the low part of trachea site and left main bronchus,especially the lower part of trachea stenosis was familiar,and moreseverity.then, Left main bronchial stenosis its narrow segment involvementof a wider range of general.2.Highest proportion of each model type II in tracheal stenosis, thedegree of stenosis, generally more severe, which mainly caused by aorticmalformation and pulmonary vascular malformation, the segment ofstenosis caused by aorta deformity general Higher, and the segment ofstenosis caused by aorta deformity general lower; And type I is mainlycaused by aortic branch deformity; Type III narrow common type ofvascular malformation is given priority to pulmonary artery malformation3.Vascular ring is the most vascular malformation which can causetracheal stenosis, and the type II was more familiar than the type I and III.the degree of stenosis was more severity than others. generally is consistentwith the level of clinical manifestations of children, should be shapedsurgical intervention as soon as possible.4.Type II tracheal stenosis (lower trachea) with vascular malformationof the directivity, each other can know about the choice of operationmethod has important significance. |
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