目的：对迷走右锁骨下夹层动脉瘤误诊为纵隔肿瘤的病例进行分析，旨在为临床后期对迷走右锁骨下夹层动脉瘤的诊断提供一定的依据。方法对1例疑似罕见迷走右锁骨下动脉夹层动脉瘤患者误诊为右纵隔肿瘤的病例进行分析，通过临床相关检查及术中所见进行观察，分析误诊的原因。结果患者病变位于食管上段主动脉弓平面， CT 特点食管右后壁增厚，管腔变窄，右上纵隔见一团块状软组织密度影，与主动脉弓界限不清；手术时发现其为迷走右锁骨下夹层动脉瘤。结论迷走右锁骨下夹层动脉瘤如对其认识不足，容易造成误诊。建议临床医师必要时采用 CT 血管造影检查，以减少误诊。%Objective To analyze misdiagnosed vagal right subclavian dissecting aneurysm cases as mediastinal tumor, so as to provide certain reference for further clinical diagnosis of vagal right subclavian dissecting aneurysm. Methods Analysis was made on 1 misdiagnosed vagal right subclavian dissecting aneurysm cases as mediastinal tumor. Observation was made on clinical examination and operation discovery to analyze causes of misdiagnosis. Results Lesion in this patient located in upper esophageal arterial arch plane, with CT featured right posterior esophageal wall incrassation, lumen stenosis, upper-right mediastinal soft tissue density shadows as crumb, and unclear boundary between arterial arch. This patient was found to be vagal right subclavian dissecting aneurysm during operation. Conclusion Lack of knowledge of vagal right subclavian dissecting aneurysm may lead to easy misdiagnosis. CT angiography is recommended for clinicians to apply in examination, in order to decrease misdiagnosis.
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