心肌桥-壁冠状动脉临床应用解剖的双源CT研究  

Applied anatomy of myocardial bridge-mural coronary artery by dual-source CT

作　　者：虞康惠[1] 成官迅[1] 刘国顺[1] 阎静[1] 

机构地区：[1]南方医科大学附属南方医院影像中心,广州510515

出　　处：《中国临床解剖学杂志》2012年第3期303-306,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省自然科学基金(S2011010003870);南方医科大学南方医院院长基金(2010B017)

摘　　要：目的研究心肌桥-壁冠状动脉(MB-MCA)的双源CT(DSCT)形态学特征,以提高对MB-MCA临床诊断价值的认识。方法分析3709例冠状动脉CTA病人,根据美国心脏病协会的冠状动脉16段分段法对检出的MB-MCA进行准确定位,对其长度、深度、收缩期管腔压缩程度及其伴随的粥样硬化情况进行评估。结果 3709例病人中发现MB-MCA 638例,检出率约17.20%,共检出654支MB-MCA,其中426支位于7段(S7)、72支位于8段(S8)、56支位于6段(S6),其余分别分布于2段(S2)、3段(S3)、4段(S4)、9段(S9)、11段(S11)、12段(S12)、13段(S13)及16段(S16);MB-MCA平均长度为(20.52±9.84)mm,平均深度为(1.27±0.93)mm;收缩期时MCA管腔呈现不同程度的狭窄,但重度狭窄罕见;92例MB-MCA患者在MCA前存在粥样硬化斑块。结论 DSCT不仅可直接显示MB-MCA的解剖形态,还可动态评价其在整个心动周期的变化,为MB-MCA临床意义的研究提供了有价值的信息。Objective To study the morphologic features of myocardial bridge-mural coronary （MB-MCA） by dual-source CT （DSCT）, and improve the understanding of it on clinical diagnosis value. Methods 3709 patients were involved in this study. MB-MCAs were located accurately according to the guideline of the American Heart Association, and the length, depth, compression of MB-MCA and concomitant atheromatous changes were evaluated. Results 638 cases had MB-MCA in overall 3709 patients by DSCT, getting the prevalence of 17.20%. 654 MB-MCA were detected including 426 in segment 7, 72 in segment 8 and 56 in segment 6, the rest distributing in segment 2, 3, 4, 9, 11, 12,13 and 16. Of 654 MB-MCA, the mean length was （20.52± 9.84）mm and the mean thickness was （ 1.27± 0.93 ）mm. The lumen of MCA showed no significant stenosis or mild to moderate stenosis, and a rare severe stenosis. 92 patients with MB-MCA had atherosclerotic plaque. Conclusions DSCT not only may directly demonstrate the dissection shape of MB-MCA, but might also dynamically evaluate the change of MB-MCA in the entire cardiac cycle, supplying the clinical significance research of MB-MCA for valuable information.

关 键 词：心肌桥 壁冠状动脉 X线计算机 体层摄影术 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学] R445.3[医药卫生—基础医学]