CTA联合超声心动图在心肌桥-壁冠脉中的应用价值  

Application value of CTA combined with echocardiography in myocardial bridge-mural coronary artery

作　　者：王丽丽[1] 高伟 朱宏伟 任继媛[1] WANG Lili;GAO Wei;ZHU Hongwei;REN Jiyuan(Department of Functional Examination,Baoding Second Hospital,Hebei Baoding 071051;Department of Neurosurgery,Baoding First Hospital,Hebei Baoding 071000;CT Room of Baoding Second Hospital,Hebei Baoding 071051,China)

机构地区：[1]保定市第二医院功能检查科,河北保定071000 [2]保定市第一医院神经外科,河北保定071000 [3]保定市第二医院CT室,河北保定071000

出　　处：《新疆医科大学学报》2021年第6期718-721,共4页Journal of Xinjiang Medical University

基　　金：保定市科学研究与发展计划项目(1941ZF008);河北省科技计划项目(19ZD092)。

摘　　要：目的探讨128排冠脉CT血管造影(CTA)联合超声心动图在心肌桥-壁冠脉(MB-MCA)中的应用价值。方法选取于2017年9月—2020年8月在保定市第二医院就诊的282例MB-MCA患者,分别采用冠脉CTA、超声心动图及二者联合诊断方式,并收集100例健康体检者的超声心动图检查结果作为对照组。观察患者壁冠脉狭窄程度CTA联合超声心动图检测结果指数,并对比不同狭窄程度对左心功能的影响。结果不同狭窄程度MB-MCA患者与健康体检者左心室收缩末期容积(ESV)、每搏输出量(SV)、舒张末期容积(EDV)、心脏输出量(CO)、左心室射血分数(EF)对比差异均有统计学意义(P<0.05),但轻度狭窄患者ESV、SV、EDV、CO、EF与中度狭窄患者相比差异无统计学意义(P>0.05),中度狭窄患者ESV、SV、EDV、CO、EF与重度狭窄患者相比差异无统计学意义(P>0.05)。在MB-MCA患者中,不同狭窄程度患者CTA检测结果差异具有统计学意义(P<0.05),其中轻度狭窄患者MB长度、厚度、MCA内径及狭窄率与中度狭窄患者相比差异具有统计学意义(P<0.05),中度狭窄患者MB长度、厚度、MCA内径及狭窄率与重度狭窄患者相比差异具有统计学意义(P<0.05)。以传统金标准冠状动脉造影结果为参照,联合超声心动图与CTA诊断MB-MCA患者的特异性是87.82%,敏感度是90.15%,高于超声心动图(52.74%,78.19%)和CTA(81.29%,82.74%),差异具有统计学意义(P<0.05)。结论128排冠脉CTA联合超声心动图检查方式在MB-MCA不同狭窄程度的患者诊断中具有较高应用价值,同时可观察并评估患者心功能变化情况。Objective To investigate the application value of 128 slice coronary CT angiography(CTA)combined with echocardiography in myocardial bridge-mural coronary artery(MB-MCA).Methods A total of 282 MB-MCA patients treated in Baoding Second Hospital from July 2018 to June 2020 were selected.Coronary CTA,echocardiography and the combined diagnosis of the two were used to observe the degree of coronary artery stenosis in the patient's wall.The echocardiographic results of 100 healthy subjects were collected as the control group.Combined with the index of echocardiographic detection results,the effects of different degrees of stenosis on left ventricular function were compared.Results There were significant differences in ESV,SV,EDV,CO and EF between the MB-MCA patients with different degrees of stenosis and normal controls(all P<0.05),but there was no significant difference in ESV,SV,EDV,CO and EF between the mild and moderate stenosis patients(all P>0.05),and also between the moderate and severe stenosis patients(all P>0.05).There were significant differences in MB length,thickness,MCA internal diameter and coarctation between the mild and moderate stenosis patients(all P<0.05),and between the moderate and severe stenosis patients(all P<0.05).With reference to the results of traditional gold standard coronary angiography,the specificity and sensitivity of combined echocardiography and CTA in the diagnosis of MB-MCA patients were 87.82%and 90.15%respectively,which were higher than those of echocardiography(52.74%,78.19%)and CTA(81.29%,82.74%)only(all P<0.05).Conclusion The 128 slice coronary CTA combined with echocardiography has a high application value in the diagnosis of different stenosis in MB-MCA patients,and it can display and evaluate the changes in patients'heart function.

关 键 词：冠脉CTA 超声心动图 心肌桥 壁冠脉 左心功能 

分 类 号：R540.4[医药卫生—心血管疾病]