狗冠状动脉的生物力学特性——Ⅱ、心外膜下各级分支的压力—直径关系

本文应用离体心脏病冠伏动脉x线造影和计算机图像处理技术,对6例狗的左、右冠状动脉心外膜下各级分支的压力—直径关系进行研究。在动脉压为8-21.3kPa范围,冠状动脉心外膜下各级分支的直径随压力变化呈线性变化(P<0.005);当动脉压力大于21.3kPa时,动脉直径不再变化,等于常数C。     

左心室乳头肌的动脉

本文采用冠状动脉造影、注射墨汁火棉胶切片法,观察了人心、狗心和兔心左室乳头肌形态和动脉分布的特点。乳头肌的形态,根据其附着心壁的程度分为:1.附着型,人心占34%;狗心占100%;兔心占38%。2.游离型,人心占28%;兔心占10%。3.中间型,人心占38%;兔心占52%。乳头肌动脉的主要来源:前外组乳头肌在人心及狗心多数由前降支发出的分支供应;兔心主要由左室支的左室前支供应。后内组乳头肌在人心、狗心主要由右或左冠状动脉的左室后支供应;兔心主要来自左室支的左室后支。乳头肌动脉的分布类型与乳头肌形态的关系:1.游离型乳头肌,主要为中央动脉型,占87.5%。2.附着型乳头肌,主要为节段动脉型,占94.29%。3.中间型乳头肌,主要为混合动脉型,占98.59%。本文测量了乳头肌血管的口径和密度,还讨论了乳头肌动脉的来源、分支分布类型在人、狗、兔的不同特点,以及对乳头肌梗塞的应用意义。     

16层螺旋CT冠状动脉图像质量评估

目的量化评估16层螺旋CT冠状动脉各分支图像质量,探讨冠状动脉CT成像的临床应用效果。方法采用16层螺旋CT对102例患者行回顾性心电门控冠状动脉成像,男60例,女42例,平均年龄（57．8±9．4）岁,平均心率（62．8±10．2）次／min。心率〈60次／min（n=40）为I组,60～70次／min（n=35）为Ⅱ组,〉70次／min（n=27）为Ⅲ组。4条冠状动脉分支（左主干、左前降支、左回旋支、右冠状动脉）分别用于图像质量分析。扫描原始数据以间隔10％在20％～80％时相分别回顾性重建冠状动脉图像,用横断面、曲面重建、容积再现等方法对冠状动脉显示率评估。用曲面重建方法测量冠状动脉各分支长度及近段和远段对比噪声比。结果①冠状动脉各分支平均显示长度：左主干（10．9±3．0）mm,左前降支（130．3±29．7）mm,左回旋支（82．8±19．8）mm,右冠状动脉（150．5±27．5）mm;②Ⅰ组60％和70％为最佳时相图像质量优,Ⅱ组60％时相为最佳时相图像质量优,Ⅲ组RCA较优的时相为40％,LM、LAD、LCX较优时相为60％。③所有冠状动脉分支平均对比噪声比10．9±3．2。结论16层螺旋CT有较好质量的冠状动脉图像,心率和时相影响冠状动脉的成像质量。     

肝内胆管树形态学定量研究

在Ｓｔｒａｈｌｅｒ分级法的基础上，以狗胆道系统的灌注模型为材料，测量了胆管树上８个级别的分支的几何参数：分支数Ｎｎ、分支直径Ｄｎ及分支长度Ｌｎｏ分析计算发现：Ｎｎ、Ｄｎ和Ｌｎ与级别数ｎ之间均可用指数函数来描述。随后的分析引入分形几何的概念，认为胆管树是一种分形结构，其显著特征是在不同尺度下所表现出来的自相似性。根据分形理论，利用上述得到的几何参数变化规律，估算出了狗胆管树的分维数Ｄ。     

经股动脉至冠状动脉插管的应用解剖观测

目的:为动脉造影术以及对病变脏器进行化学治疗时的导管插入提供解剖学依据。方法:用不锈钢尺测量从股动脉起始处至冠状动脉起始处全程中主动脉各主要分支的距离;用游标卡尺测得各动脉起始部的外径。结果:从左、右股动脉起始处,经髂外动脉、髂总动脉最终到左冠状动脉起始处之间的长度分别为(68.9±4.2)cm和(69.0±3.9)cm;到右冠状动脉起始处之间的长度分别为(68.3±4.0)cm和(68.5±3.6)cm。左、右冠状动脉起始处的外径分别为(6.2±1.3)mm和(5.0±0.8)mm。结论:本文的测量数据可供经股动脉至冠状动脉起始处全程中主动脉的各主要分支施行心导管诊断治疗和对内脏器官的疾病进行化学治疗以及局部脏器动脉造影术参考。     

右冠状动脉开口异位1例

在局部解剖的过程中,发现右冠状动脉开口位置异常1例(附图),报道如下:下,动脉口直径为0.4cm,其主干先在升主动脉根部与肺动脉干之间紧贴升主动脉壁向右行走0.9cm距离,继行于肺动脉与右心耳下方的右冠状沟内,向右绕过右缘至膈面走行于后室间沟,于心尖处与前室间支末梢吻合,沿途分支有:右圆锥支、右室支、右缘支、右房支、房事结支。左冠状动脉开口于左主动脉窦内,动脉口直径为0.4cm,心脏其它部位未见异常。 本例右冠状动脉分支和分布虽属正常,但其始段贴着升主动脉壁行走,当主动脉充盈扩张时,可能影响到右冠状动     

心第3冠状动脉的解剖学

目的:研究心第3冠状动脉的大体解剖学数据,为临床诊治相关疾病提供依据。方法:共收集了118个福尔马林固定的心,观测心第3冠状动脉数量、来源、分布范围、营养区域和长度及管径等解剖学数据。结果:第3冠状动脉出现率为28.8%,其中单支出现率为26.3%,双支出现率为2.5%。它通常分布于动脉圆锥、右心室前壁、室间隔及心尖中的1个或多个位置,也有些少见情况:第3冠状动脉比右冠状动脉大并结束于心尖;第3冠状动脉比右冠状动脉小且结束于心尖;心肌桥覆盖较大的第3冠状动脉。结论:心存在第3冠状动脉情况较多,它与左冠状动脉前降支吻合且分布于心尖和室间隔。因此第3冠状动脉是在疾病诊疗期间需要着重考虑的一个因素。     

冠状动脉的解剖学观察 六、左、右冠状动脉在心室独立壁的分布范围和吻合

<正> 一、左、右冠状动脉在心室独立壁的分布范围(表一) 最单纯的是左室前壁,除了3例靠近钝缘的小部分地区接受右冠状动脉的终支分布外,全受左冠状动脉分布。右室前、后壁和左室后壁多数由左、右冠状动脉共同分布。其中76例右室前壁除受右冠状动脉分布外,其接近前室间沟的小部分地区受前降冠状动脉的室支分布;71例右室后壁除受右冠状动脉分布外,有60例其接近心尖的小部分地区受前降冠状动脉的末支分布,有11例其接近后室间沟的部分地区受左旋冠状动脉或左横冠状动脉的分支分布;81例左室后壁除受左旋冠状动脉的纯缘支和前降冠状动脉的末支     

心室壁动脉分布的图象分析及其临床意义

用大体解剖、血管铸型、X 线造影方法,观测了108例心冠状动脉行程以及其中100例成人心冠状动脉分布于心室壁的状况。冠状动脉供应范围具有个体差异,变化最多的是在心膈面。对其中38例成人心膈面的冠状动脉分布范围用图象分析仪进行分析,国人右冠状动脉分布范围超过左冠状动脉者为多数占81.6%:左冠状动脉分布范围大于右冠状动脉者占10.5%;左、右冠状动脉分布相当者占7.9%。其分布面积:左冠状动脉平均为2935±1375mm~2;右冠状动脉为4875±1887mm~2,从图象分析结果看,亦是右冠状动脉分布占优势.说明国人心膈面缺血性疾患进行诊断时,应对右冠状动脉给予更多的注意。     

长白猪与成年人房室交点区的解剖学比较

目的 观测家猪房室交点区解剖学特征,为比较解剖学积累资料.方法 采用30例长白猪心脏在新鲜状态下测量房室交点区相关数据,建立几何模型处理数据.10％甲醛固定48 h后,用过氯乙烯—丙酮填充剂灌注左、右冠状动脉及其分支,心大静脉及其属支.解剖并观测房室交点区结构.结果 左、右后房室沟和后室间沟呈“Y”型相交.后房间沟呈弧...     

Myocardial bridges over coronary arteries in Cercopithecus.

The presence of myocardial bridges over the coronary arteries has been studied in 29 monkey (Cercopithecus aethiops) hearts. The great resemblance between the Cercopithecus subepicardial arterial net with the corresponding one in humans has been revealed. There is a high incidence (83%) of myocardial bridges only over the ventricular branches of both coronary arteries. Myocardial bridges are usually (90%) located over the left coronary artery branches, and the left anterior interventricular branch is the most frequently (69%) overbridged vessel. The bridges are always single over the vessel examined and their length varies from 0.5 mm to 31.6 mm. No statistically significant sexual difference in myocardial bridges distribution is reported.     

冠脉分支交错分布的研究

为了证实大白鼠的冠脉分支在心肌中相互交错分布的问题,我们在大白鼠的冠脉左室支和左旋支之间,将心肌的外2/3层作阻断性处理。结果阻断线两侧的局部血流量出现明显的对称性下降。这种变化很可能是由于阻断了向对侧互相交错分布的冠脉分支引起的,因此可以认为,大白鼠冠脉分支在心肌中是互相交错分布的。     

The arterial blood supply of the conducting system in normal human hearts

The distributing artery of the conducting system of the heart is occasionally injured in cardiac surgery. The aim of this study was to define the anatomic characteristics of the principal arterial source of the sinu-atrial node and atrioventricular node. Furthermore, the morphology of the tendon of Todaro was clarified. Thirty hearts were studied by gross anatomic methods, and the exact area of the conducting system was supported by histologic observations of four hearts. The sinu-atrial node was supplied by the right coronary artery more frequently (73% of cases) than by the left (3%), and in 23% of cases this node was supplied by both coronary arteries. The atrioventricular node was supplied by the right coronary artery (80% of cases) more than by the left (10%), and in 10% of the cases this node was supplied by both coronary arteries. The atrioventricular bundle branch arose from the right coronary artery in 10% of cases, the left coronary artery in 73%, and both coronary arteries in 17%. Most of the blood to the right bundle (the moderator band) was supplied by the interventricular septal branches of the anterior interventricular branch from the left coronary artery. Finally, all the arteries of the right bundle and left bundle were defined to be derived from left coronary arteries.     

Extracardiac coronary arterial anastomoses

The collateral arterial circulation of the heart has been extensively studied. However, less attention has been paid to extracardiac anastomoses, which may also be of significant clinical importance. In this review, we will describe the most common types of these anastomoses, which include bronchial to coronary arteries and internal thoracic to coronary arteries. In a much lesser degree, anastomoses between coronary arteries and pericardiacophrenic branches of the internal thoracic arteries, anterior mediastinal arteries, intercostal arteries, and esophageal arterial branches have also been described. Knowledge of the likely morphology and function of the anastomoses, therefore, could prove helpful in the clinical evaluation of patients with myocardial ischemia, particularly when selecting candidates for myocardial revascularization.     

Anatomy of the coronary arteries in fetal pigs: comparison with human anatomy

In this study, 94 fetal pigs were used to comprehensively investigate the origins, number, location, and distribution of the coronary arteries to enrich knowledge on the coronary circulation in fetal pigs, and allow comparison with adult pigs and humans. In fetal pigs, the posterior interventricular sulcus branch always arose from the right coronary artery and the circumflex artery was rarely extended to the posterior interventricular sulcus, while it is variable in humans. In fetal pigs, there was sometimes anastomosis (8.5%) between the left and right conus branches as nutrient arteries of the pulmonary cone. Other branches were not significantly different between fetal pigs and humans, including the acute marginal branch, obtuse marginal branch, and sinoatrial nodal artery. Coronary dominance was also similar. In conclusion, compared with adult pigs, dissection of the coronary arteries in fetal pigs provided a more faithful overview of the porcine coronary circulation. The coronary arteries in fetal pigs were also more suitable for comparison with humans when pigs are used as experimental animals for studying the coronary vessels, which could be an important reference for investigation of clinical treatment of the coronary arteries. In summary, our data provide reliable information about the distribution and ramifications of the coronary arteries, and could be useful for clinicians and surgeons who wish to comprehensively understand coronary anatomy.     

Atherosclerotic lesions in the common coronary arteries of ApoE knockout mice.

OBJECTIVE: The present study describes the distribution of atherosclerotic lesions in the coronary arteries of chow-fed 60-week-old male ApoE(-/-), 17-beta-estradiol-treated ApoE(-/-), and wild-type mice. METHODS AND RESULTS: The histologic examination of coronary arteries in 12 ApoE(-/-) and 6 wild-type mice, in contrast to the distribution of atherosclerosis in human coronary arteries, reveals that the major lesions in the mouse are located in the valve sinus, including the origins of the coronary arteries. These retrovalvular lesions either stop abruptly at the orifice of the common coronary artery or extend a short distance onto the arterial trunks. The first segment and first branch of all the major coronary arteries, the usual sites of disease in humans, are protected from disease. Although the arterial trunks and the first level branches are free of disease, we found approximately four independent lesions per heart. Independent lesions are present in the heart in smaller, intramyocardial vessels. These lesions are comprised predominantly of macrophages and proteoglycan and exhibit little extracellular lipid. In some cases, the independent lesions occlude the lumen without evidence of myocardial infarct in the surrounding tissue. CONCLUSIONS: The specificity of the localization of lesions in certain segments of the murine coronary tree suggests that fundamental properties found at different branch levels determine lesion location.     

动脉圆锥的动脉解剖学观察

目的 动脉圆锥的动脉解剖学观察。方法 在50例经动脉灌注红色乳胶的成年国人尸体上及在5例冠状动脉塑型标本上解剖观察心脏动脉圆锥的动脉供应。结果 动脉圆锥的动脉大都来源于右冠状动脉的圆锥支和左冠状动脉前室间支的动脉圆锥支,它们大都在动脉圆锥部吻合。结论 本文研究了动脉圆锥部的动脉供应及其吻合,为临床应用提供了形态学依据。     

人体骶尾骨的动脉供应——骨外部分

本实验用解剖、透明、X线摄片和腐蚀铸型等方法研究了56例不同年龄新鲜尸体的骶尾骨骨外动脉的配布。骶骨的动脉供应主要来自骶外侧动脉、骶中动脉、髂腰动脉和腰最下动脉。骶中动脉、骶外侧动脉及其分支在骶骨腹侧面相互吻合形成骶前格子状动脉吻合网。椎管前支在椎间孔内侧分为升降二支,相邻升降支间在椎体背面相互吻合,两侧升降支间呈横形吻合。在骶椎椎体背侧形成菱形的骶管腹侧动脉网。椎管后支在椎板腹侧面亦分为升降二支,同侧及两侧升降支间在椎板腹侧形成梯状的骶管背侧吻合网。骶外侧动脉的背侧支出骶后孔即分为内侧支、肌支和外侧支。内侧支在骶中嵴两侧分为上下二支,相邻上下支之间形成骶中嵴动脉网。外侧支在骶骨外侧部分为升降二支,亦形成吻合。尾骨腹侧面的动脉来自骶中动脉和骶外侧动脉,背侧面主要由骶外侧动脉的终支供应。尾骨表面的动脉吻合稀少。     

基于血管平行性和拓扑性的冠脉树分割

本研究提出了一种基于血管平行性和拓扑性的冠脉树分割方法。利用冠脉的曲率和平行性，获取冠脉段的边缘；利用冠脉的连通性和拓扑性，获取整个冠脉树的边缘。本方法的优点是，冠脉树的跟踪是从中心初始点到冠脉的末梢点，跟踪冠脉树的拓扑结构与真实冠脉的拓扑结构接近，解决了大冠脉段分支被分成几段的缺点，使冠脉段达到了很好的连续性；利用血管边缘的平行性和连通性，能找出准确冠脉的配对边缘，很好的解决了由三维图像投影为二维图像冠脉之间的部分重叠和遮挡问题。上述方法能获取完整、单连通和单像素的冠脉树边缘。实验结果表明，本研究提出的方法有很好的准确性。