目的 评价MSCT与DSA对儿童先天性支气管动脉-肺动脉瘘显示的一致性.方法 先天性支气管动脉-肺动脉瘘患儿16例,其中6例因不明原因每日反复咯血200～400ml而接受多层螺旋CTA及DSA检查以及选择性支气管动脉栓塞治疗；其余10例因先天性心脏病就诊,均诊断为动脉导管未闭(PDA),接受多层螺旋CTA及DSA检查.结果 DSA显示16例患儿共20支支气管动脉,均存在支气管动脉-肺动脉瘘.CTA显示20支支气管动脉,与DSA的显示率(20/20,100％)一致；其中13支呈增生性改变,管腔内径2～4 mm,11支可见支气管动脉-肺动脉瘘.6例大咯血患儿经选择性支气管动脉栓塞治疗后效果良好,咯血症状消失.所有患儿随访平均时间为165天(1～12个月),均未发现复发咯血.结论 多层螺旋CTA能够显示部分支气管动脉-肺动脉瘘的直接及间接征象,但对于观察肺内支气管动脉-肺动脉瘘以及隐匿的支气管动脉-肺动脉瘘有一定局限性,诊断仍需借助DSA检查.%Objective To assess the agreement of MSCTA and DSA in displaying congenital malformation of bronchial artery-pulmonary artery fistula in children. Methods Sixteen children with congenital malformation of bronchial artery-pulmonary artery fistula were selected. Six children presenting with hemoptysis (200 to 400 ml/day) underwent MSCTA, DSA examination and then received selective bronchial artery embolization. The other 10 children with congenital heart disease were diagnosed as patent ductus arteriosus (PDA) and underwent MSCTA and DSA examination. Results Totally 20 bronchial arteries were found in 16 children. DSA showed bronchial artery-pulmonary artery fistula in all the 20 bronchial arteries. MSCTA displayed all the 20 bronchial arteries with the same of DSA (20/20, 100%). Thirteen bronchial arteries appeared bronchial arterial proliferation with diameter of 2-4 mm, and 11 were found with bronchial artery-pulmonary artery fistulas. The affected arteries were satisfactorily embolized in 6 children presenting with hemoptysis, and the endovas-cular treatment was clinically successful. The mean short-term follow-up in all 16 cases was 165 days (1-12 months) , and nonehemoptysis reoccurred. Conclusion Multi-slice spiral CTA can partly display the direct and indirect signs of bronchial artery-pulmonary artery fistula, but as for those locating in the lung and non-obvious ones, diagnosis still depends on DSA.
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