Doppler echocardiography and MR angiography for diagnosis of systolic murmurs in pulmonary sequestration
| Autor: | Tatsuo Shimizu, Takuya Kosumi, Mitsugu Owari, Hiroshi Tamai, Takeo Yonekura |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Aortography Doppler echocardiography Magnetic resonance angiography Pulmonary vein Pulmonary sequestration medicine.artery Medicine Humans Bronchopulmonary Sequestration Vein Aorta medicine.diagnostic_test Heart Murmurs business.industry Infant medicine.disease Echocardiography Doppler Color medicine.anatomical_structure Descending aorta Pediatrics Perinatology and Child Health cardiovascular system Radiology business Magnetic Resonance Angiography |
| Zdroj: | The Journal of pediatrics. 145(5) |
| ISSN: | 0022-3476 |
| Popis: | A 1-month-old boy was referred from another institution because of a systolic murmur. A grade 2 systolic murmur was heard at the left lower sternal border with radiation to the left chest and back. A chest radiograph showed slight cardiomegaly and theelectrocardiogram showed mild left ventricular volume overload. Echocardiography showed no cardiac abnormalities, except for mild left ventricular volume overload. Meticulous color Doppler examination of the aorta showed anteriorly directed arterial blood flow arising from the descending aorta in the retrocardiac region above the left hemidiaphragm (Figure, A). Magnetic resonance angiography (MRA) with contrast enhancement revealed a single large artery that ran leftward and downward from the descending aorta in the retrocardiac region above the left hemidiaphragm (Figure, B and D). Abnormal vessels were also observed to the left of the descending aorta in the retrocardiac region (Figure, B and C). The left lower pulmonary vein was dilated, so venous drainage was considered to occur through this vein. From these findings, a diagnosis of sequestration of the left lower lobe was strongly suspected. Aortography displayed a single large artery (diameter, 8 mm; length, 20 mm) arising from the descending aorta. Surgery revealed an intralobar sequestration in the left lower lobe that showed normal communication with the tracheobroncheal tree and received its arterial blood supply from the descending aorta via a single large artery (diameter; 8 mm, length; 20 mm) (Pryce type 1). 1 Venous drainage was through the left lower pulmonary vein. Lobectomy of the left lower lobe was performed. The definitive diagnosis of pulmonary sequestration is usually made by aortography, but noninvasive methods are preferable, especially in young patients such as neonates or infants. Doppler echocardiography and MRA were useful for the diagnosis of pulmonary sequestration presenting as a vascular murmur in an infant. |
| Databáze: | OpenAIRE |
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