冠状动脉CT血管成像对心肌桥收缩期压迫程度的诊断价值  

Diagnostic value of coronary CT angiography in myocardial bridge systolic compression

作　　者：周蕊[1] 李健[1] 郭庆乐[1] 乔建民[1] ZHOU Rui;LI Jian;GUO Qing-le;QIAO Jian-min(Department of Radiology,Kailuan General Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]开滦总医院放射科,河北唐山063000

出　　处：《川北医学院学报》2022年第4期490-493,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨冠状动脉CT血管成像(CCTA)对心肌桥收缩期压迫程度的诊断价值。方法:收集行CCTA检查的110例心肌桥患者的临床资料,根据收缩期壁管腔狭窄率,将患者分为显著压迫组(n=38,收缩期狭窄率≥50%)、轻度压迫组(n=40,收缩期狭窄率10%~49%)和无压迫组(n=32,收缩期狭窄率<10%)。根据CCTA图像,进行管腔内CT值的测定,计算心肌桥段管腔内平均CT值,及心肌桥段近段管腔内平均CT值,计算管腔密度衰减梯度(TAG)=(心肌桥段近段官腔内平均CT值-心肌桥段管腔内平均CT值)/心肌桥段近段官腔内平均CT值×100%。比较各组CCTA参数差异,并应用受试者工作特征曲线(ROC)评价CCTA参数诊断心肌桥压迫程度的效能。结果:相比无压迫组,显著压迫组或轻度压迫组TAG、心肌桥长度和心肌桥深度均增大(P<0.05);相比轻度压迫组,显著压迫组TAG、心肌桥长度和心肌桥深度均增大(P<0.05)。ROC曲线分析显示,CCTA参数TAG、心肌桥长度和心肌桥深度均对心肌桥收缩压迫程度有一定诊断效能,其中以TAG诊断效能最高,其诊断显著压迫和存在压迫的曲线下面积(AUC)分别为0.891(95%CI=0.817~0.942)和0.899(95%CI=0.826~0.948)。结论:CCTA参数TAG、心肌桥长度和心肌桥深度均与心肌桥收缩期压迫程度相关,尤其是TAG对收缩期压迫程度的诊断价值最高。Objective:To investigate the diagnostic value of coronary CT angiography(CCTA)in myocardial bridge systolic compression.Methods:A total of 110 patients with myocardial bridge who underwent CCTA examination were collected.According to the stenosis rate of the wall lumen during the contraction period,the patients were divided into the obvious indigenous compression group(n=38,the stenosis rate during the contraction period≥50%),the mild compression group(n=40,the stenosis rate during the contraction period 10%~49%)and the non-compression group(n=32,the stenosis rate during the contraction period<10%).According to the CCTA image,the intracavitary CT value was measured,and the average intracavitary CT value of myocardial bridge segment and the average intracavitary CT value of myocardial bridge segment were calculated.Transluminal attenuation gradient(TAG)=(average intracavitary CT value of myocardial bridge segment-average intracavitary CT value of myocardial bridge segment)/average intracavitary CT value of myocardial bridge segment×100% was calculated.The differences of CCTA parameters in each group were compared,and the receiver operating characteristic curve(ROC)was used to evaluate the efficacy of CCTA parameters in diagnosing myocardial bridge compression.Results:Compared with the non-compression group,the TAG,myocardial bridge length and myocardial bridge depth in the significant compression group or the mild compression group increased(P<0.05).Compared with the mild compression group,the TAG,myocardial bridge length and myocardial bridge depth in the significant compression group were increased(P<0.05).ROC curve analysis showed that the TAG,myocardial bridge length and myocardial bridge depth had a certain diagnostic efficiency for the degree of myocardial bridge contraction compression,and the TAG had the highest diagnostic efficiency.The area under the curve of diagnosing obvious compression and compression was 0.891(95%CI:0.817-0.942)and 0.899(95%CI:0.826-0.948),respectively.Conclusion:The TAG,myocardi

关 键 词：心肌桥 冠状动脉压迫 冠状动脉血管造影 体层摄影术 

分 类 号：R541.1[医药卫生—心血管疾病] R816.2[医药卫生—内科学]