室壁瘤39例冠状动脉造影分析  

Ventricular Aneurysm:An Angiographic Analysis of 39 Cases

作　　者：杨厚林[1] 陈良生[1] 王尔祯[1] 林秋萍[1] 

机构地区：[1]福建省立医院放射科,350001

出　　处：《福建医药杂志》2001年第2期8-9,共2页Fujian Medical Journal

摘　　要：目的　分析冠心病室壁瘤的造影表现、好发部位及其与冠状动脉病变的关系。方法　分析连续 393例冠状动脉造影中 39例室壁瘤的造影表现 ,统计左室各部位室壁瘤的例数 (百分比 )、冠状动脉病变支数与狭窄程度。结果　39例均为真性室壁瘤 ,其中 37例为解剖性室壁瘤 ,2例为功能性室壁瘤。左心室造影表现为心室局部呈囊袋样凸隆 ,室壁运动消失或矛盾运动 ,造影剂排空延迟。解剖性室壁瘤肌小梁消失 ,瘤壁光滑 ,功能性室壁瘤仍可见肌小梁。解剖性室壁瘤中 ,30例 (81.1% )累及左室前侧壁心尖部 ,其中 3例同时累及膈面 ,7例下壁 ,其中 1例合并肌部室间隔穿孔。2 7例 (6 9.2 % )为双支或三支病变 ,8例 (2 0 .5 % )为单支病变 ,2例 (5 .1% )冠状动脉未见狭窄 ,左前降支病变 31例 (79.5 % )。结论　室壁瘤的发生部位与其供血冠状动脉病变相对应 ,好发于左室前侧壁心尖部。左室及冠状动脉造影可明确室壁瘤的发生部位与性质、冠状动脉病变情况 。Objective:To explore the angiographic manifestation of ventricular aneurysm(VA),predilection site of VA,and the relation between the location of VA and lesion of coronary artery.Methods:To explore the angiographic manifestations of the 39 cases with VA,they were detected from 393 consecutive cases of coronary artery angiography.Count up the number of cases (percent)of VA involved each location of the left ventricular wall and the number of stenosed coronary arteries and the grade of their stenosis.Result:All the 39 cases were true VA,of them 37 cases anatomical VA,2 cases functional VA.The angiographic manifestations in the left ventricle angiography are as follows:part of the left ventricle was convex like a bag,movement of the local ventricular wall was missing or contradictory,contrast medium were removed delaying;myocardial trabeculae disappeared,the wall was smooth in the cases of anatomical aneurysm,but they were still there in functional aneurysm.Among the group of anatomical aneurysm,the antero lateral wall or/and apex of the left ventricle were involved in 30 cases(81 1%),3 cases of them involved the lower part too,lower part were involved merely in 7 cases,ventricular septum was perforated in 1 case.Double or triple vessel stenosis of coronary arteries were found in 27(69 2%) and single vessel stenosis 8(20 5%) cases,the coronary arteries were normal in 2 cases(5 1%);The LAD was involved up to 31 cases (79 5%).Conclusion:The location of VA of left ventricle and the stenosed coronary arteries are related,and the anterolateral wall or/and apex of the left ventricle are predilection locations.Left ventricle and coronary artery angiography can point out the location and the nature of VA and stenosis of the coronary artery definitely,and guide treatment

关 键 词：左心室室壁瘤 冠状动脉造影 诊断 

分 类 号：R816.2[医药卫生—放射医学]