CTA诊断双左前降支变异的患病率和影像特征  

Prevalence and Imaging Features of Dual Left Anterior Descending Branch Variation Diagnosed by CTA

作　　者：吴启源 贾雷 庞茂华 孔许强 许荣睿 覃兴长 周华[1] 袁明远[1] WU Qi-yuan;JIA Lei;PANG Mao-hua;KONG Xu-qiang;XU Rong-rui;QIN Xing-chang;ZHOU Hua;YUAN Ming-yuan(Department of Radiology,Zhoupu Hospital Affiliated To Shanghai University of Medicine&Health Sciences,Shanghai 201318,China)

机构地区：[1]上海健康医学院附属周浦医院放射科,上海201318

出　　处：《中国CT和MRI杂志》2025年第3期87-89,共3页Chinese Journal of CT and MRI

基　　金：上海市浦东新区卫生健康委员会卫生计生科研项目(No.PW2022A-52)。

摘　　要：目的了解双左前降支变异的发病率,并通过冠状动脉CTA检查明确其影像学形态特征,以提高对双左前降支的认识。方法回顾性分析23846例在本院行冠状动脉CTA的影像学报告,查询双左前降支的存在例数。本文回顾了本院双左前降支患者的CTA影像表现,并对双左前降支的形态学特征进行了归纳和总结。结果在本研究人群中,0.14%的患者存在双左前降支,其中I型双左前降支变异是最常见的亚型(76.5%),短支前降支心肌桥比长支心肌桥多见(P<0.001),短支前降支主要发出室间隔支(P<0.001),长支前降支主要发出对角支(P<0.001),长前降支及短前降支在斑块形成方面没有统计学意义(P>0.05)。结论双左前降支变异有多种亚型,I类型发病率最高。在所有双前降支变异中,短支前降支心肌桥明显多于长支前降支,绝大多数对角支来源长前降支,绝大多数室间隔支来源短前降支,两者在斑块形成无差别。随着冠状动脉CTA的广泛应用,掌握双左前降支影像表现特征很重要,能给临床医生提供重要的操作路径信息。Objective To understand the incidence of double left anterior descending branch variation and to clarify its imaging morphological features by coronary artery CTA examination in order to improve the understanding of double left anterior descending branch.Methods The imaging reports of 23846 cases of coronary artery CTA in our hospital were analyzed retrospectively to find out the number of cases with double left anterior descending branch.In this paper,the CTA findings of patients with double left anterior descending branch in our hospital were reviewed,and the morphological features of double left anterior descending branch were summarized.Results In this study,0.14%of the patients had double left anterior descending branch,in which type I double left anterior descending branch variation was the most common subtype(76.5%).The myocardial bridge of short anterior descending branch was more common than that of long branch(P<0.001).The anterior descending branch of short branch mainly sent out interventricular septal branch(P<0.001),and the anterior descending branch of long branch mainly sent out diagonal branch(P<0.001).There was no significant difference in plaque formation between long anterior descending branch and short anterior descending branch(P>0.05).Conclusion There are many subtypes of double left anterior descending branch variation,and type I has the highest incidence.In all the double anterior descending branch variations,the myocardial bridge of the short anterior descending branch was significantly more than that of the long anterior descending branch,and most of the diagonal branches originated from the long anterior descending branch and the interventricular septal branch from the short anterior descending branch,which had no difference in the formation of plaques.With the wide application of coronary artery CTA,it is very important to master the imaging features of double left anterior descending branch,which can provide clinicians with important operation path information.

关 键 词：冠状动脉CT血管造影 双前降支 先天性冠状动脉异常 

分 类 号：R543.3[医药卫生—心血管疾病]