不完全与完全心肌桥对冠状动脉形态及粥样硬化影响的iCT研究  

The Effect of the Incomplete and Complete Myocardial Bridging on the Atherosclerosis and Morphology of the Coronary Artery

作　　者：赵新斌[1] 赵鹤亮[1] 傅昱[2] 张惠英[1] 齐志[1] 

机构地区：[1]河北联合大学附属医院CT室,唐山063000 [2]河北省唐山市第九医院CT室,063000

出　　处：《临床放射学杂志》2012年第10期1401-1405,共5页Journal of Clinical Radiology

摘　　要：目的采用256层螺旋CT冠状动脉成像对比分析不完全与完全心肌桥(myocardial bridge,MB)对冠状动脉形态及粥样硬化的影响。方法回顾性分析经256层螺旋CT冠状动脉成像诊断为MB-壁冠状动脉(mural cor-onary artery,MCA)的160例患者的影像资料,根据MB形态将其分为不完全与完全MB,分别比较两组在MCA、桥前段、桥后段与整支冠状动脉粥样硬化发生率以及MCA邻近血管成角出现率的差异。比较桥前段冠状动脉粥样硬化组与无粥样硬化组及MCA邻近血管成角组与正常组MB长度的差异。结果不完全MB组MCA、桥前段、桥后段及整支冠状动脉粥样硬化发生率分别为0、29.35%、8.69%、38.04%,MCA邻近血管成角出现率为21.74%;完全MB组MCA、桥前段、桥后段及整支冠状动脉粥样硬化发生率分别为0、60.29%、7.35%、67.64%,MCA邻近血管成角出现率为69.12%。两组桥前段(χ2=15.323,P=0.000)、整支冠状动脉粥样硬化发生率(χ2=13.709,P=0.000)及MCA邻近血管成角出现率(χ2=36.060,P=0.000)差异有统计学意义,而MCA及桥后段冠状动脉粥样硬化发生率差异无统计学意义(χ2=0.094,P=0.759)。桥前段冠状动脉粥样硬化组与无粥样硬化组MB长度分别为(11.75±5.49)mm、(11.22±4.71)mm,差异无统计学意义(t=0.596,P=0.511)。MCA邻近血管成角组与正常组MB长度分别为(11.76±5.53)mm、(12.17±4.88)mm,差异无统计学意义(t=-0.497,P=0.620)。结论与不完全MB相比,完全MB更易诱发桥前段冠状动脉粥样硬化的形成,更易使MCA邻近血管迂曲成角,但MB形态对MCA及桥后段冠状动脉粥样硬化的发生影响不明显,从而导致整支冠状动脉粥样硬化发生率增加。而MB长度则与桥前段冠状动脉粥样硬化的发生及冠状动脉形态无明显相关性。Objective To study the effect of the incomplete and complete myocardial bridge（MB）on the atherosclerosis and morphology of the coronary artery with 256-slice spiral CT coronary angiography.Methods The myocardial bridge,mural coronary artery（MB,MCA）of 160 patients undergoing 256-slice spiral CT coronary angiography were collected and analyzed retrospectively.The subjects were divided into incomplete and complete MB group.MCA,the segments proximal and distal of MB,the global coronary artery were evaluated for atherosclerosis rate,and the angulation frequency of the coronary artery containing MB was also explored between these two groups.The group with atherosclerosis in the proximal vessels of MB was compared with the other group without atherosclerosis in the length of MB.The length of MB between the vessel tortuousness and normal groups was explored.Results It showed statistically significant difference in atherosclerosis rate in the proximal vessels of MB（χ2=15.323,P=0.000）and the global coronary artery（χ2=13.709,P=0.000）between the incomplete and complete MB groups.So was the morphology of the coronary artery containing MB（χ2=36.060,P= 0.000）.A significant difference was not found in MCA,the segments distal of MB（χ2=0.094,P=0.759）.The length of MB between the atherosclerosis group in the proximal vessels of MB and comparative group did not find a significant difference（t=0.596,P=0.511）.There was not significant difference between the vessel tortuousness and normal groups in the length of MB（t=-0.497,P=0.620）.Conclusion The complete MB is easier to get coronary atherosclerosis in proximal segment of MB and to cause coronary tortuousness of proximal or distal vessels than the incomplete MB.But the morphology of MB does not effect the atherosclerosis rate in MCA and the segments distal vessels of MB.So the complete MB is prone to cause more atherosclerosis rate in the global coronary artery containing MB.There is not significant correlation between the length of MB and the morph

关 键 词：心肌桥 动脉粥样硬化 冠状动脉造影术 体层摄影术 X线计算机 

分 类 号：R541.1[医药卫生—心血管疾病] R816.2[医药卫生—内科学]