CT冠状动脉成像诊断心肌桥的价值:与传统冠状动脉造影对照分析  

Diagnosis of Myocardial Bridges:A Comparison Between Computed Tomography and Invasive Coronary Angiography

作　　者：古今[1] 史河水[1] 韩萍[1] 刁楠[1] 曾秋棠[1] 喻杰[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2013年第5期644-648,共5页Journal of Clinical Radiology

基　　金：高等学校博士学科点专项科研基金项目(编号:20090142110047)

摘　　要：目的对比分析均行CT冠状动脉成像(CTCA)和传统冠状动脉造影(CAG)检查患者的影像学资料,探讨CTCA对心肌桥诊断的临床应用价值。方法回顾性分析83例同时行CTCA及CAG检查患者的影像学资料。图像分析采用双盲法,由两名放射科诊断医师及两位介入科医师分别在不知道CTCA及CAG诊断结果的前提下协商作出心肌桥的诊断,计算CTCA及CAG对心肌桥的检出率并采用χ2检验进行比较。结果 83例患者中CTCA显示41例共48处心肌桥,检出率为49.40%,CAG显示19例共19处冠状动脉"挤牛奶"效应,检出率为22.89%。与CTCA对照,CAG显示的19处心肌桥与其位置一致,其中15处为完全性心肌桥,4处为不完全心肌桥。CTCA对心肌桥的检出率高于CAG(χ2=12.633,P<0.001)。结论 CTCA能多方位、直观显示冠状动脉与心肌的解剖关系,对心肌桥的显示优于CAG,且具有无创检查的优点。Objective To assess the value of CT coronary angiography （CTCA） in diagnosing myocardial bridges, and compared with invasive coronary angiography （CAG）. Methods A total of 83 cases （ male 58, female 25 ; mean age 63 years） who received both dual-source CT coronary angiography and CAG exam were reviewed retrospectively for myocardial bridges. CTCA and CAG images were analyzed by two cardiovascular and interventional radiologists who did not know the results of CTCA and CAG. Calculate the detection rate of myocardial bridges diagnosed in CTCA and CAG and compared the difference using χ^2 test. Results CTCA detected 41 cases and a total of 48 myocardial bridges, the rate were 49.4% （41/83）. CAG revealed 19 patients and a total of 19 myocardial bridges which were the same as that detected in CTCA ex-amination, the detection rate was 22.9% （ 19/83 ）. Compared the difference of detection rate between CTCA and CAG, there were significant difference （ χ^2 = 12. 633 ,P 〈 0.001 ）. Conclusion CT coronary angiography can display the anato-my relationship between coronary artery and myocardium directly and non - invasive, which is better than CAG.

关 键 词：心肌桥 壁冠状动脉 体层摄影术 X线计算机 冠状动脉造影 

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