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A Case Report of Thoracic Enhanced Chest CT Combined with Endobronchial Ultrasound for the Diagnosis of Asymptomatic Bronchial Dieulafoy's Disease
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摘要: 本文报道1例采用胸部增强CT结合支气管内超声(endobronchial ultrasound, EBUS)诊断的罕见无症状支气管Dieulafoy病患者，胸部增强CT可见左主支气管内结节样新生物，动脉期部分强化，支气管镜检查示左主支气管远端结节样黏膜隆起，表面光滑，可见细小血管，未见搏动，未行活检，行EBUS探查病灶支气管黏膜下血流情况，可见明显彩色血流信号。根据上述表现考虑诊断为支气管Dieulafoy病。对于未发生咯血的患者，如支气管镜检查有主气道结节样新生物，可采用胸部增强CT结合EBUS明确诊断，避免盲目活检而导致致死性大出血，该方法无创、安全且有效易行，值得临床推广应用。
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关键词:
- 支气管Dieulafoy病 /
- 支气管内超声 /
- 胸部增强CT /
- 咯血
Abstract: We reported a rare case of asymptomatic bronchial Dieulafoy's disease diagnosed by enhanced chest CT combined with endobronchial ultrasound (EBUS). The enhanced chest CT showed nodular neoplasm in the left main bronchus and partial enhancement in arterial phase. Bronchoscopy showed nodular mucosal protrusion lesion at the distal end of the left main bronchus, and the protrusion lesion had smooth surface and no pulsation, with some microvessels on it, and obvious submocasal blood flow signals were seen by endobronchial ultrasound. The diagnosis of bronchial Dieulafoy disease was considered based on the above findings and biopsy was not performed. In patients without haemoptysis, if there are nodular neoplasms in the main airway on bronchoscopy, enhanced chest CT combined with EBUS can be used to diagnose bronchial Dieulafoy's disease and avoid fatal haemorrhage due to conventional biopsy. The method is non-invasive, safe and effective, and worthy of clinical application. -
作者贡献：赵静、林宜亭负责研究设计、操作实施、数据收集整理、论文撰写及修订；李运奎、张晓彤、赵媛媛、陈勇、陈珂琪负责数据收集整理；王孟昭负责病例诊治、论文审校。利益冲突：所有作者均声明不存在利益冲突注：本研究发表已获得患者知情同意。
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[1] Sweerts M, Nicholson AG, Goldstraw P, et al. Dieulafoy's disease of the bronchus[J]. Thorax, 1995, 50: 697-698. http://thorax.bmj.com/content/50/6/697.abstract
[2] Parrot A, Antoine M, Khalil A, et al. Approach to diagnosis and pathological examination in bronchial Dieulafoy disease: a case series[J]. Respir Res, 2008, 9: 58. http://core.ac.uk/download/pdf/81537116.pdf
[3] Qian X, Du Q, Wei N, et al. Bronchial Dieulafoy's disease: a retrospective analysis of 73 cases[J]. BMC Pulm Med, 2019, 19: 104. http://www.socolar.com/Article/Index?aid=200253243488&jid=200000025497
[4] Zhou P, Yu W, Chen K, et al. A case report and review of literature of Dieulafoy's disease of bronchus: A rare life-threatening pathologic vascular condition[J]. Medicine (Baltimore), 2019, 98: e14471. http://www.ncbi.nlm.nih.gov/pubmed/30762767
[5] Liao SX, Sun PP, Li BG, et al. A rare and fatal respiratory disease: bronchial Dieulafoy's disease[J]. Ther Adv Respir Dis, 2020, 14: 1753466620929236. http://www.socolar.com/Article/Index?aid=200253269341&jid=200000015654
[6] Padilla-Serrano A, Estrella-Palomares V, Martínez-Palacios B, et al. A case of massive hemoptysis related to a smoking-history: an acquired form of the Dieulafoy's disease?[J]. Rev Port Pneumol, 2015, 21: 276-279. http://www.onacademic.com/detail/journal_1000038398139310_716b.html
[7] Chen W, Chen P, Li X, et al. Clinical characteristics and treatments for bronchial Dieulafoy's disease[J]. Respir Med Case Rep, 2019, 26: 229-235. http://doc.paperpass.com/foreign/rgArti2019396620742.html
[8] van der Werf TS, Timmer A, Zijlstra JG. Fatal haemorrhage from Dieulafoy's disease of the bronchus[J]. Thorax, 1999, 54: 184-185. http://pdfs.semanticscholar.org/abb8/df31d340221cda6ec332e00f7d7a7f4eced4.pdf
[9] Gurioli C, Casoni GL, Gurioli C, et al. Endobronchial ultrasound in Dieulafoy's disease of the bronchus: an additional application of EBUS[J]. Monaldi Arch Chest Dis, 2010, 73: 166-168. http://www.researchgate.net/profile/Venerino_Poletti/publication/50849042_Endobronchial_ultrasound_in_Dieulafoy&
[10] Ganganah O, Guo S, Chiniah M, et al. Endobronchial ultrasound and bronchial artery embolization for Dieulafoy's disease of the bronchus in a teenager: A case report[J]. Respir Med Case Rep, 2015, 16: 20-23. http://www.sciencedirect.com/science/article/pii/S2213007115000313/pdfft?md5=c744faa76b21cd5611559507bddb12f7&pid=1-s2.0-S2213007115000313-main.pdf
[11] 潘峰, 王芳, 刘卓, 等. 支气管Dieulafoy病的支气管动脉CT造影特点[J]. 中华结核和呼吸杂志, 2018, 41: 949-953. [12] Colt HG, Davoudi M, Murgu S. Scientific evidence and principles for the use of endobronchial ultrasound and transbronchial needle aspiration[J]. Expert Rev Med Devices, 2011, 8: 493-513. http://www.onacademic.com/detail/journal_1000037359315510_1bbf.html
[13] Mincholé E, Penin RM, Rosell A. The Utility of Linear Endobronchial Ultrasound for the Incidental Finding of Dieulafoy Disease of the Bronchus[J]. J Bronchology Interv Pulmonol, 2018, 25: e48-e50. http://www.ncbi.nlm.nih.gov/pubmed/30247294
[14] Casoni GL, Gurioli C, Romagnoli M, et al. Diagnosis of pulmonary thromboembolism with endobronchial ultrasound[J]. Eur Respir J, 2008, 32: 1416-1417.
[15] 胡惠蓉, 曾奕明, 洪苓苓. 气道内超声检查对气道黏膜隆起病变的诊断价值[J]. 中华结核和呼吸杂志, 2016, 39: 514-518. [16] 张建峰, 叶健, 陈灏, 等. 结合气道内超声诊断支气管Dieulafoy病1例[J]. 中国乡村医药, 2015, 24: 70-74. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYY201524038.htm [17] Chen Y, Mao Y, Cheng X, et al. Case Report: A Case of Infant Bronchial Dieulafoy's Disease and Article Review[J]. Front Pediatr, 2021, 9: 674509. http://www.socolar.com/Article/Index?aid=100090471859&jid=100000011556
[18] 贾卫红, 杨栋才, 侯飞飞, 等. 支气管Dieulafoy病30例临床误诊分析[J]. 临床误诊误治, 2019, 32: 4-8. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWZ201907003.htm [19] 杨瑞红, 李剑锋, 刘军, 等. 支气管Dieulafoy病三例并文献复习[J]. 中华结核和呼吸杂志, 2013, 36: 577-580. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJSA201606023.htm [20] Dalar L, Sökücü SN, Özdemir C, et al. Endobronchial argon plasma coagulation for treatment of Dieulafoy disease[J]. Respir Care, 2015, 60: e11-e13.
[21] 刘丽琼, 李艳丽, 刘艳红, 等. 支气管Dieulafoy病的诊治进展[J]. 中华结核和呼吸杂志, 2016, 39: 127-130. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX201304022.htm
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