左冠状动脉主干高位开口及冠状动脉前降支肺动脉瘘的心肌首过灌注初步研究  

Left Main Coronary Artery High Takeoff and Anterior Descending Artery-Pulmonary Artery Fistula: First-Pass Myocardial Perfusion Study

作　　者：周娟[1] 赵本新 龙镜亦 陆静[2] 孙运秀[2] 史河水[2] 

机构地区：[1]江苏省人民医院放射科,210029 [2]武汉协和医院放射科,430022

出　　处：《临床放射学杂志》2015年第1期51-54,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81271570)

摘　　要：目的比较单纯性左冠状动脉主干高位开口及冠状动脉前降支肺动脉瘘患者与正常对照组心肌首过灌注的差异。方法搜集2013年1月至9月左冠状动脉前降支肺动脉瘘6例,单纯性左冠状动脉主干高位12例,采用多层螺旋CT血管成像(MSCTA)行轴位扫描,应用东芝后处理工作站进行前降支供血区心肌首过灌注分析,将单纯性左冠状动脉主干高位、左冠状动脉前降支肺动脉瘘与正常组冠状动脉的舒张期和收缩期心肌灌注校正值(c-MP)进行比较,分析冠状动脉变异对心肌首过灌注的影响。结果冠状动脉前降支肺动脉瘘舒张期和收缩期c-MP值均低于正常组;单纯性的左冠状动脉主干高位与正常组的收缩期和舒张期的c-MP值无明显差异。结论冠状动脉前降支肺动脉瘘的首过灌注效应的初步性研究,在一定程度上反映冠状动脉前降支瘘的供血区情况,冠状动脉前降支肺动脉瘘的患者舒张期和收缩期的c-MP值均减低,当存在前降支肺动脉瘘时,前降支支配区心肌的首过灌注减低,是患者发生心肌缺血的潜在原因之一。Objective To investigate the first-pass myocardium perfusion （MP） in patients with simple left coronary ar- tery high takeoff and anterior descending artery-pulmonary coronary artery fistula by using dual-source CT coronary angiogra- phy （CTA）, and to compared it with that in normal control subjects. Methods During the period from January to Sep- tember 2013, 6 patients with left coronary anterior descending artery-pulmonary artery fistula and 12 patients with simple left coronary artery high takeoff were admitted to authors＇ hospital. Using the axial images obtained by multi-slice CT angi- ography, the first-pass myocardium perfusion of myocardial area supplied by left coronary artery anterior descending branch was analyzed on a Toshiba post-processing workstation. The diastolic and systolic c-MP values （ corrected myocardial perfu- sion value） of the left coronary artery high takeoff group, left coronary anterior descending artery-pulmonary artery fistula group and the normal control group were separately determined, the resuhs were compared among the three groups, and the influence of coronary abnormality on the first-pass myocardium perfusion was evaluated. Results Both the diastolic and systolic c-MP values in left coronary anterior descending artery-pulmonary artery fistula group were lower than those in the control group, while the diastolic and systolic c-MP values in simple left coronary artery high takeoff group were not signifi- cantly different from those in the control group. Conclusion This preliminary study indicates that the first-pass myocardi- um perfusion can reflect the blood supply of left coronary anterior descending artery-pulmonary artery fistula to a certain ex- tent. In patients with left coronary anterior descending artery-pulmonary artery fistula both the diastolic and systolic c-MP values are decreased, and the first-pass myocardium perfusion will be reduced in the cardiac area supplied by left coronary artery anterior descending branch when left coronary anterior descen

关 键 词：左冠状动脉开口高位 冠状动脉瘘 心肌灌注 

分 类 号：R543.3[医药卫生—心血管疾病]