双源CT显示心肌桥的价值  

Myocardial bridging on dual-source CT： comparison with conventional coronary angiography

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

机构地区：[1]南京军区南京总医院医学影像科,210002

出　　处：《中华医学杂志》2008年第12期826-829,共4页National Medical Journal of China

摘　　要：目的与常规冠状动脉造影（CAG）对照，评价双源cT冠状动脉血管成像（DSCTCA）检出心肌桥（MB）的价值。方法53例患者同时进行DSCTCA和CAG。其中16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前、后及MB处在收缩期（40．0％）和舒张期（70．0％）的管径，计算MB处在收缩期的狭窄率及其与“挤牛奶效应”出现的关系。结果53例患者中，DSCTCA检出16例患者有21处MB，检出率30．2％；CAG检出3例患者4处MB，检出率5．7％。在患者和MB的基础上，DSCTCA和CAG检出MB的差异均有统计学意义（x^2=10．837，P=0．001）。16例MB患者的4D电影显示MB存在不同程度的“挤牛奶效应”及血液逆流。MB在收缩期狭窄程度与“挤牛奶效应”出现率有关（r=0．640，P=0．006）。结论双源CT可较CAG更可靠地再现CAG上的“挤牛奶效应”，可作为常规的筛查方法用于排除或检出MB。Objective To assess the ability to detect myocardial bridging （MB） of dual-source computed tomography （DSCT） compared with conventional coronary angiography （CAG）. Methods Both DSCT coronary angiography （DSCTCA） and CAG were performed on 53 patients diagnosed or suspected as with coronary artery disease （CAD）, 45 males and 8 females, aged 36-87. 4D cine mode was performed on 16 of these 53 patients with MB shown on DSCTCA, and the CAG data were reviewed retrospectively by automatic cine method. The MB findings by both methods were compared. The diameters of segments proximal to and distal to MB, tunneled coronary arteries at systolic and diastolic phases were measured, and stenosis rate of tunneled coronary arteries was computed according to the equation. The relationship between stenosis rate of tunneled artery and milking effect on 4D cine mode was analyzed. Results Of the 53 patients who had undergone CAG;4 images of MB were detected in 3 patients based on the CAG findings, with a detection rate of 5.7%, significantly than that by DSCT （50.2%, 21 images of MB in 16 patients, X^2 = 10. 837, P = 0. 001 ）. 4D cine mode showed various degrees of ＂milking effect＂ and abnormal blood flow in 16 patients with MB. The stenosis rate of tunneled artery during systole was related to the ＂milking effect＂ rate on 4D cine mode of DSCTCA （ r = 0.640, P = 0.006）. Conclusion More vividly and reliably showing the ＂milking effect＂ than CAG, DSCT can be used as a routine screening method to detect or exclude MB.

关 键 词：体层摄影术 X线计算机 冠状动脉疾病 血管造影术 

分 类 号：R686[医药卫生—骨科学]