Usefulness of magnetic resonance angiography in the diagnosis of systemic origin of an aberrant artery to the basal segment of the lung: Description of two cases *
A definitive diagnosis of pulmonary anomalous systemic arterial supply requires angiographic visualization of the anomalous feeding artery and draining vein. We report two patients with systemic origin of an aberrant artery to the basal segment of the lung. Magnetic Resonance Angiography (MRA) was found to be as effective as routine angiography in visualization of these abnormal vessels. MRI and MRA especially are safe, noninvasive and useful alternatives for the diagnosis of anomalous systemic arterial supply to the basal lung. A 15-year-old boy was admitted to our hospital because of a left chest murmur on auscultation. Chest computed tomography (CT) showed a tumorous shadow in the left posterior basal segment (S l0). MRA clearly disclosed aberrant arteries arising from the thoracic aorta. Chest tomography showed no defect in visible bronchi. Aortography showed one aberrant artery arising from the thoracic aorta, circulating in the basal segment of the left lower lobe, and returning to the left pulmonary vein. A pulmonary arteriogram revealed a defect of A8~10. Based on the above described examinations, this case was diagnosed as a case of systemic arterial supply to a normal basilar segmant of the left lung. Resection of left lower lobe was performed. In the resected specimen, the bronchi of the left lower lobe had a normal structure and showed a normal pattern of distribution. The other patient, a 61-year-old man was referred to our hospital after an abnormal shadow was found in the left lobe of the lung by a chest X-ray film and a plain CT scan. Chest enhanced CT revealed a tumorous shadow in the left posterior basal segment (S 10). MRA showed that this shadow consisted of tumorous vessels and was connected to the abdominal aorta. The left bronchial tree appeared normal during fibroptic bronchoscopy. From these findings, we determined that this patient had an systemic arterial supply to the normal basal segments. (Accepted on December 20, 1999) Kawasaki Igakkaishi 26(1) : 25-31, 2000
