心肌桥的双源CT四维电影显示与常规冠状动脉造影的对照分析  

Myocardial bridging:the comparison between 4D cine of dual-source CT and conventional coronary angiography

作　　者：张龙江[1] 卢光明[1] 郭华[2] 陈鹏[1] 孙志远[1] 王俊鹏[1] 李林[1] 黄伟[1] 

机构地区：[1]南京军区南京总医院医学影像科,江苏南京210002 [2]南京军区南京总医院心脏内科,江苏南京210002

出　　处：《中国医学影像技术》2007年第11期1654-1658,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的利用双源CT四维电影模式观察心肌桥(MB)在整个心动周期的变化,并与常规冠状动脉造影(CAG)对照,探讨其诊断MB的临床意义。方法2006年12月到2007年3月,共有15例患者行双源CT冠状动脉血管成像(DSCTCA)显示为MB的患者同时进行了CAG。15例患者的DSCTCA和CAG数据分别以4D电影模式重组和回放,对照分析两者显示MB的价值。在4D影像上分别测量MB处在收缩期(40%)和舒张期(70%)的管径,计算其在收缩期的狭窄率及其与"挤牛奶效应"出现的关系。结果15例MB患者,CAG提示4处MB,DSCTCA显示20处MB,两者之间的差别有统计学意义(P<0.001)。15例MB患者的4D电影显示MB存在不同程度的"挤牛奶效应"。与DSCTCA的MPR显示的χ2检验显示差别无统计学意义(P=0.231);与CAG相比,4D电影更多地检出了MB的这种典型征象,两者之间的差别有统计学意义(P<0.001)。MB在收缩期狭窄的程度与"挤牛奶效应"出现率有关(r=0.640,P=0.006)。结论双源CT四维电影模式可较CAG更生动地再现CAG上的"挤牛奶效应",结合常规的后处理技术可作为MB诊断的有用技术。Objective To observe the changes of myocardial bridging（MB）in entire cardiac cycle using four dimensional cine mode on dual-source computed tomography（DSCT）,and to compare with conventional coronary angiography（CAG）to investigate its diagnostic implications in MB.Methods Between December 2006 and March 2007,15 patients with MB shown on dual-source CT coronary angiography（DSCTCA）underwent CAG.MB on DSCTCA were shown using four dimensional cine mode,and CAG data were reviewed retrospectively at automatic cine method.MB findings on both methods were compared.The diameters of tunneled coronary arteries at systolic and diastolic phase were measured,and stenosis rate was computed according to the equation.The relationship between stenosis rate of tunneled artery and milking effect on four dimensional cine mode was analyzed.Results Of 15 patients underwent CAG,four MB were detected;however,20 MB were detected on DSCT（P〈0.001）.Four dimensional cine mode showed typical ＂milking effect＂ induced systolic compression of tunneled segment.Four dimensional cine mode showed various degree of ＂milking effect＂ in 15 patients with MB.There was no statistical significance between MPR and four dimensional cine mode in showing MB（χ^2test,P=0.231）,whereas;statistical significance between CAG and four dimensional cine mode in showing MB was found（χ^2test,P〈0.001）.Four dimensional cine mode detected more MB than did CAG.Stenosis rate of tunneled artery during systole related to ＂milking effect＂ on four dimensional cine mode of DSCTCA（r=0.640,P=0.006）.Conclusion Four dimensional cine mode of DSCTCA can more vividly show ＂milking effect＂ than CAG,combination of four dimensional cine and conventional post-processing techniques can be used as a useful technique for diagnosis of MB.

关 键 词：心肌桥 体层摄影术 X线计算机 电影显示 

分 类 号：R542.2[医药卫生—心血管疾病] R814.42[医药卫生—内科学]