摘要： 目的 探讨多层螺旋CT 血管造影术（CTA）诊断迷走右锁骨下动脉的临床应用价值。方法 对5800 例接受头颈部联合CTA 检查患者的临床资料进行回顾分析，结合原始数据、最大密度投影、曲面重组及容积再现三维技术，观察迷走右锁骨下动脉及其伴发的其他主动脉弓分支变异。结果 共检出迷走右锁骨下动脉伴左位主动脉弓患者52 例，其中单纯性21 例（40.38%），合并双侧颈总动脉共干19 例（36.54%），合并一侧椎动脉起源异常9 例（17.31%），迷走右锁骨下动脉、颈总动脉共干合并左侧椎动脉起自主动脉弓3 例（5.77%）；Kommerell 憩室10 例（19.23%），无一例Kommerell 憩室发生动脉瘤样改变。结论 多层螺旋CTA 能够很好地评价迷走右锁骨下动脉及其伴发的其他主动脉弓分支变异，对临床有重要意义。

关键词: 锁骨下动脉, 先天畸形, 主动脉, 胸, 体层摄影术, 螺旋计算机, 血管造影术

Abstract: Objective  To evaluate the application value of multidetector computed tomography angiography (MDCTA) in the diagnosis of aberrant right subclavian artery (ARSA).  Methods  Retrospective analysis were applied on 5800 patients who underwent MDCTA on head and neck, and then the ARSA and other accompanied variations of branches of aortic arch were observed on using original images, maximum intensity projection (MIP), curved planar reformation(CPR) and volume rendering (VR).  Results  ARSA combined with left aortic arch was found in 52 cases, among which simple ARSA was seen in 21 cases (40.38%), ARSA with bilateral common carotid trunk (CCT) in 19 patients (36.54%), ARSA and anomalous origin of unilateral vertebral artery in 9 patients (17.31%), ARSA, CCT and left vertebral artery (LVA) originating from aortic arch in 3 cases (5.77%). Among the 52 ARSA cases, Kommerell diverticulum was found in 10 cases (19.23% ), and no aneurysmal change was seen in Kommerell diverticulums.  Conclusion  MDCTA can accurately reflect ARSA and other accompanied variations of branches of aortic arch, and is significant for clinical practice.

Key words: Subclavian artery, Congenital abnormalities, Aorta, thoracic, Tomography, spiral computed, Angiography