双源CT对心肌桥-壁冠状动脉的检测及其临床意义  

The depiction of myocardial bridge-mural coronary artery with dual-source computed tomography and its clinical significance

作　　者：刘世合[1] 李春卫[2] 马子堂[3] 贾守勤[2] 柳澄[2] 

机构地区：[1]山东大学医学院2006年级硕士研究生,山东济南250012 [2]山东省医学影像学研究所,山东济南250021 [3]山东省济宁市妇女儿童医院,山东济宁272000

出　　处：《中国中西医结合影像学杂志》2009年第1期20-23,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的：用双源CT（DSCT）观察心肌桥一壁冠状动脉（MB-MCA）的检出率及解剖学特征，探讨DSCT对MB-MCA的诊断价值。方法：用DSCT对450例可疑冠心病（CHD）和部分体检者行冠状动脉血管成像（CTA），2名CT诊断医师独立判断MB-MCA的存在，结果一致时确定为MB-MCA。测量壁冠状动脉（MCA）的长度、心肌桥（MB）的厚度，结果用^-x±s表示。采用多平面重组（MPR）、曲面重组（CPR）、容积再现（VR）多种后处理技术相结合观察MCA近端及远端血管形态变化。结果：450例可疑CHD和体检者，冠状动脉CTA发现MB-MCA 163例（36．2％，163／450），192处。MB-MCA位于左前降支者153处，占79．7％（153／192）。合并MB-MCA近端血管管腔内粥样硬化斑块形成者107例（55．79／，107／192），合并近端及远端均形成斑块者3例（1．6％，3／192）。MCA长度为（20．0±10.1）mm，MB厚度为（2．1±0．9）mm。结论：临床怀疑CHD者MB-MCA检出率为36．2％，DSCTCA是一种无创而且直观准确诊断MB-MCA的方法。Objective： To investigate the depiction of myocardial bridge and mural coronary artery with dual-source computed tomography （DSCT） and its clinical significance . Methods： Four hundred and fifty patients suspected as coronary artery disease （CHD） underwent dual source computed tomography and all the data was analyzed by 2 radiologists independently. When consistency was obtained among the independent results, the diagnosis of MB-MCA could be confirmed. The length of MCA and depth of MB were measured. MIP, CPR and VR were used to observe the anatomical characteristics and the morphological changes proximal and distal to the mural coronary artery. Results： One hundred and ninty-two sites of MB-MCA were found in 163 （18.6%） of the 450 patients,153 of the 192 sites of MB-MCA were located on the LAD （79.7G）. Coronary atheroselerosis was found proximal to the myocardial bridge in 107 of the 192 sites （55.7G） ,proximal and distal to the myocardial bridge in 3 of the 192 sites （1.6%）. The length of MCA was （20.0±10.1） mm,and the depth of MB which part of a coronary artery was completely surrounded by myocardium was （2.1 ± 0.9） mm. Conclusion： The prevalence of MB-MCA in this study is 36.2%. DSCT coronary angiography is a non-invasive,efficient method in the diagnosis of MB-MCA.

关 键 词：冠状血管畸形 体层摄影术 X线计算机 冠状动脉狭窄 

分 类 号：R541.1[医药卫生—心血管疾病]