左反回神経麻痺を呈した胸部大動脈瘤の4症例

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We have reported the necessity of obtaining a CT scan in old patients who have recurrent nerve paralysis, even if their routine chest x-ray films and other exminations show normal appearance.
In this study, the authors report four cases of the left recurrent laryngeal nerve paralysis caused by small aortic aneurysma in the part of aortic arch. They are all over 60 year-old males.
A mass in the aortopulmonary (A-P) window was detected in case 1 and 2 by plain chest x-ray films, and diagnosed as aneurysma by means of enhanced CT scan and MRI-CT (Magne tic Resonance Imaging).
A mass was not detected in the A-P window in case 3 and 4 by plain chest x-ray films. On CT scan and MRI-CT examination, a mass was found and diagnosed not as small aneurysma with thrombs but as a metastatic tumor of Botallo's lymphnode.
The study revealed the following:
1. CT scan and MRI-CT examination are very useful in diagnosis of the mass in the A-P window
2. CT examination should be obtained in patients over 60-year old who have recurrent laryngeal nerve paralysis, even if their chest xray films show normal appearance.
3. In a case of small aneurysma with large thrombs, enhaned CT and MRI-CT examination were not useful in diagnosis.