多层螺旋CT评估心肌桥及伴发血管粥样硬化病变的诊断价值  

Diagnostic Value of Multi-slice Spiral CT in the Assessment of Myocardial Bridge and Associated Atherosclerotic Lesions

作　　者：李宁[1] 韩丽英[1] 王俊伟[1] 赵秀峰[1] 常超[1] 刘丽军[1] 信栓力[1] LI Ning, HAN Li-ying,WANG Jun-wei,ZHAO Xiu-feng,CHANG Chao, LIU Li-jun,XIN Shuan-li,(Department of Cardiology,the First Hospital of Handan City,Handan 056000,Hebei,China)

机构地区：[1]河北邯郸市第一医院心内科,河北邯郸056000

出　　处：《医学信息》2018年第19期152-154,157,共4页Journal of Medical Information

基　　金：河北邯郸市科技研发计划项目(编号:1623208041ZC)

摘　　要：目的探讨256层螺旋CT评估心肌桥及伴发血管粥样硬化病变的诊断价值。方法回顾性收集接受256层螺旋CT检查并于30 d内行选择性冠脉造影检查的(疑似冠心病患者)101例患者相关资料。统计多层螺旋CT和CAG对心肌桥的检出率及检出心肌桥的位置分布;并测量心肌桥的长度,CT血管成像评估载心肌桥-壁冠状动脉冠脉分支粥样硬化的狭窄程度。结果 256层螺旋CT检出16例患者共18段心肌桥,检出率为15.84%,其中最常见的心肌桥部位是前降支中段心肌桥为16段,出现率为88.89%(16/18)。CAG仅检出4例患者共4段心肌桥,检出率为3.96%。256层螺旋CT测量心肌桥的平均长度为(27.20±16.30)mm,CAG证实的CTA评价的载MB-MCA血管节段狭窄程度≥50%有5段(27.78%),CAG证实的CTA评价的载MB-MCA血管节段近段狭窄程度≥50%有6段(33.33%)。结论 256层螺旋CT对心肌桥的检出率明显高于CAG;更清晰显示心肌桥形态结构,并可观察伴发血管的粥样硬化病变。Objective To evaluate the diagnostic value of 256-slice spiral CT in the evaluation of myocardial bridge and associated atherosclerotic lesions.Methods A retrospective collection of 101 patients with 256-slice spiral CT and 30 d elective coronary angiography（suspected patients with coronary heart disease）was performed.The multi-slice spiral CT and CAG were used to detect the myocardial bridge and the location of the myocardial bridge was detected.The length of the myocardial bridge was measured.CT angiography was used to evaluate the degree of atherosclerosis in the myocardial bridge-wall coronary artery.Results A total of 18 myocardial bridges were detected in 16 patients with 256-slice spiral CT.The detection rate was 15.84% .The most common myocardial bridge was the 16-segment myocardial bridge in the middle anterior descending artery, and the incidence rate was 88.89% （16/18）.CAG only detected 4 patients with a total of 4 segments of myocardial bridge,the detection rate was 3.96%.The average length of myocardial bridge measured by 256-slice spiral CT was （27.20±16.30）mm,and the CAG-confirmed CTA evaluation of MB-MCA vascular stenosis was≥50% with 5 segments （27.78%）.CAG-confirmed CTA evaluation of MB-MCA vessel segment proximal stenosis ≥ 50% has 6 segments （33.33%）.Conclusion The detection rate of myocardial bridge by 256-slice spiral CT is significantly higher than that of CAG;the morphological structure of myocardial bridge is more clearly displayed,and the atherosclerotic lesions associated with blood vessels can be observed.

关 键 词：心肌桥 256层螺旋CT 选择性冠脉造影 

分 类 号：R816.2[医药卫生—放射医学]