医学影像英语每日读丨129Giant bilateral pulmonaryArteriovenousMalformations

每天朗读一段医学影像学英语文章

领读：林源慈老师

Giant bilateral pulmonary arteriovenous malformations presenting with refractory hypoxemia

A 63-year-old woman with alcoholic cirrhosis presented with a 2-week history of dyspnea, platypnea, and orthodeoxia. Physical examination revealed clubbing of fingers and oxygen saturation on room air of 70-75% sitting which improved to 80-85% with laying down. Arterial blood gas (ABG) showed elevated alveolar-arterial (A-a) gradient of 65 mmHg. Echocardiography with bubble study revealed right to left shunt. Pulmonary CT angiography showed bilateral arteriovenous malformations (AVMs) (Figure 1). Hepatopulmonary syndrome (HPS) was confirmed. Embolotherapy was performed and the patient’s oxygen requirement improved from 30-liter high-flow nasal cannula to room air, making her a surgical candidate for liver transplantation. HPS is characterized by hypoxemia, platypnea, and orthodeoxia in the presence of liver disease, and portal hypertension (1). Early diagnosis could limit unnecessary medical management and lessen potential harm.

Notes:

1. arteriovenous malformation 动静脉畸形

2. refractory [rɪˈfræktəri] adj. 难治疗的

3. hypoxemia [ˌhaɪpɒk'si:mɪr] n. 血氧不足

4. cirrhosis [səˈroʊsɪs] n. 肝硬化

5. dyspnea [dɪsp'ni:ə] n. 呼吸困难

6. platypnea [p'lætɪpnɪr] 平卧呼吸

7. orthodeoxia [ɔ:t'hɒdi:ɒksɪr] 直立低氧血症

8. clubbing of fingers 杵状指

9. oxygen saturation [ˈɑksɪdʒən ˌsætʃəˈreʃən] 血氧饱和度

10. alveolar [æl'vi:ələr] adj. 肺泡

11. echocardiography [ekoʊkɑ:dɪ'ɒgrəfɪ] n. 超声心动图

12. shunt [ʃʌnt] v. 分流

13. Hepatopulmonary syndrome 肝肺综合征

14. Embolotherapy ['embəlɒðerəpɪ] 栓塞治疗

15. nasal cannula [ˈnezəl ˈkænjələ] 鼻套管

16. mmHg.  abbr.毫米汞柱（millimetre（s） of mercury ）

翻译：妙然

【Giant bilateral pulmonary arteriovenous malformations 巨大的双侧肺动静脉畸形】
双侧巨大肺动静脉畸形伴难治性低氧血症。
63岁女性酒精性肝硬化患者，伴呼吸困难、平卧呼吸、直立性低氧血症2周。体格检查可见杵状指，室内坐立时氧饱和度为70-75%，平卧时80-85%。动脉血气分析显示肺泡动脉血成分升高，达65mmHg。超声心动图微泡造影显示右向左分流。肺CTA显示双侧肺动静脉畸形。确诊为肝肺综合征，行栓塞治疗，患者需氧量有所改善，从鼻套管30L高流量吸氧降至室内自然空气，可以进行肝移植。肝肺综合征特征表现为低氧血症、平卧呼吸和直立性缺氧血症，伴肝病和门静脉高压。尽早诊断可以减少不必要的药物治疗，降低潜在的风险。

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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