双源CT对冠状动脉解剖变异的诊断价值  

The diagnosis value of dual-source CT coronary angiography in coronary anatomical anomalies

作　　者：李佩玲[1] 徐克[1] 谢秀丽[1] 董玉姝[1] 

机构地区：[1]中国医科大学附属第一临床学院放射科,辽宁沈阳110001

出　　处：《解剖科学进展》2011年第6期552-555,共4页Progress of Anatomical Sciences

基　　金：辽宁省教育厅课题基金(No.20060971);辽宁省科学技术计划项目(No.20092250085)

摘　　要：目的探讨双源CT冠状动脉血管造影在诊断冠状动脉解剖变异中的应用价值。方法回顾性分析2009年5月至2010年03月间于我院接受冠状动脉CT造影检查并发现解剖存在变异者38例,发生率约1.25%,其中男性29例,女性9例,年龄11-75岁。利用双源CT进行冠状动脉血管造影检查,后处理方法包括容积重建(VR)、曲面重建(CPR)和最大密度投影(MIP)等。主要观察冠状动脉主要分支的起源、走行与分布。结果 38例冠状动脉解剖异常中左侧24例,包括左冠状动脉高位开口3例、左前降支起自右侧冠状动脉窦5例、左回旋支与左前降支双开口9例、左回旋支开口于右冠状动脉窦4例、左回旋支起自右冠状动脉1例和左回旋支缺如2例。右侧冠状动脉解剖异常8例,包括右冠状动脉开口于左冠状动脉窦3例、开口于左前降支2例、右冠状动脉高位开口2例、右侧冠状动脉缺如1例;另有冠状动脉瘘6例。结论双源CT冠状动脉造影对冠状动脉解剖变异的诊断准确率较高,是一种可靠的无创性检查方法。Objective To explore the clinical diagnosis value of dual-source CT coronary angiography（DSCTCA）in coronary anomalies of human.Methods 3032 cases who accepted DSCTCA examination were retrospectively reviewed,among which 38 cases of coronary anomalies were diagnosed（29 males and 9 females,age range of 11 to 75）,with 1.25 percent of coronary anomalies rate.Post-processing techniques including volume rendering（VR）,cured planar reconstruction（CPR）and maximum intensity projection（MIP）were used to observe the origination,course and distribution of coronary.Results 24 cases of left coronary anomalies were found in 38 cases of coronary anomalies including 3 cases of left main coronary artery（LCA）with high take-off above left aortic sinus,5 cases of left anterior descending（LAD）branch originated from right coronary artery sinus,9 cases of separate ostia of left circumflex（LCx）artery and LAD,4 cases of LCx openning at right coronary artery sinus,1 case of LCx originated from right coronary artery（RCA）and 2 case of LCx absent.8 cases of right coronary anomalies were found including 3 cases of RCA openning at left coronary artery sinus,2 cases of RCA openning at LAD,2 cases of RCA with a high take-off above right coronary artery sinus and 1 case of RCA absent.Moreover,6 cases of coronary artery fistulae were diagnosed.Conclusion DSCTCA is a reliable noninvasive diagnostic method and possesses a high accuracy in diagnosis of coronary anomalies.

关 键 词：冠状动脉 变异 体层摄影术 X线计算机 血管造影术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.3[医药卫生—放射医学]