编织冠状动脉的血管内超声及光学相干断层显像影像特点  

Image characteristics of woven coronary artery on intravascular ultrasound and optical coherence tomography

作　　者：孔令秋[1] 李燕伟[1] 董勇 伍洲[1] 黄大军[1] 殷拥军[1] 葛均波 Kong Lingqiu;Li Yanwei;Dong Yong;Wu Zhou;Huang Dajun;Yin Yongjun;Ge Junbo(Department of Cardiology,Teaching Hospital of Chengdu University of Traditional Chinese Medcine,610072 Chengdu,China;Department of Cardiology,Zhengzhou Cardiovascular Disease Hospital,450016 Zhengzhou,China;Department of Cardiology,Zhongshan Hospital of Fudan University,200032 Shanghai,China)

机构地区：[1]成都中医药大学附属医院心内科,610072 [2]郑州市心血管病医院心内科,450016 [3]复旦大学附属中山医院心内科,上海200032

出　　处：《中华超声影像学杂志》2021年第1期20-24,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金青年基金项目(81603615)。

摘　　要：目的总结编织冠状动脉(WCA)的血管内超声(IVUS)及光学相干断层显像(OCT)影像特点。方法选取2013年1月至2020年7月于成都中医药大学附属医院、复旦大学附属中山医院、郑州市心血管病医院就诊,且冠状动脉造影疑诊WCA的患者37例,进行腔内影像学分析,总结确诊为WCA患者的IVUS及OCT特点。结果37例入选者中,共确诊WCA患者9例(24.3%),其中累及右冠状动脉6例、前降支2例和回旋支1例;WCA病变节段平均长度2.2 cm(范围1.2~4.5 cm)。WCA造影的直接征象为冠状动脉的某一处分出多条细小管腔,这些管腔沿着主血管走形方向缠绕而行,形成"麻花辫"样的编织网,随后再次汇合成一条正常血管。病变血管段长短不一,除非合并冠状动脉粥样硬化,其血流多数不受限。OCT及IVUS显示局部管腔存在多个螺旋管腔,彼此独立且每一隧道均有较为完整的三层血管结构。结论WCA具有典型的IVUS和OCT影像特征,借助IVUS及OCT有助于提高WCA检出率并指导治疗决策。Objective To investigate the image characteristics of woven coronary artery(WCA)on intravascular ultrasound(IVUS)and optical coherence tomography(OCT).Methods Thirty-seven patients suspected of WCA on coronary angiography were enrolled from Teaching Hospital of Chengdu University of Traditional Chinese Medcine,Zhengzhou Cardiovascular Disease Hospital and Zhongshan Hospital of Fudan University from January 2013 to July 2020.The intraluminal imaging features of WCA were analyzed using IVUS and OCT.Results Of the 37 patients admitted at the cardiology service,9 patients had WCA.All the patients underwent coronary angiography,IVUS and OCT,of which 6 lesions were located on the right coronary artery,2 lesions were located on the left anterior descending artery and 1 patient had WCA on the circumflex artery.The mean length of WCA lesions was 2.2 cm(ranged from 1.2 cm to 4.5 cm).The angiographic appearance of WCA was numerous small tortious channels origined form the main lumen.The channels appeared to be"doughnut"like pattern and they merged to normal artery again after the anomalous segment.Flow limitation was rare unless there was coronary atherosclerosis.OCT and IVUS showed multiple spiral channels in the anomalous segment,which were independent of each other and each channels had a relatively complete three-layers vascular structure.Conclusions With typical image characteristics,IVUS and OCT are able to screen out WCA and guide the treatment decision making.

关 键 词：血管内超声 光学相干断层显像 冠状动脉疾病 编织冠状动脉 

分 类 号：R543.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]