探究128层CT血管造影心肌桥-壁冠状动脉图像特征及与冠脉动脉粥样硬化的相关性

目的探讨128层CT血管造影心肌桥-壁冠状动脉(MB-MCA)图像特征及与冠脉动脉粥样硬化的相关性。方法收集2018年1月至12月于我院进行冠状动脉成像检查的126例患者临床及影像学资料,总结所有患者MB-MCA检出率情况及与冠状动脉硬化的相关性。结果126例患者MB-MCA检出率为65.08%,其中LAD中段检出率最高,浅表型最为多见;CT检出位于MB-MCA近侧动脉硬化斑块发生率最高(63.41%,P<0.05),检出MB-MCA患者斑块检出率为(52.22%)与未检出MB-MCA患者斑块检出率(45.45%)比较无差异(P>0.05);且CT检出MB-MCA患者累及段数和斑块的狭窄程度与未检出MB-MCA患者相比较无统计学意义(P>0.05),但检出MB-MCA患者的斑块主要分布于动脉近段,而未检出MB-MCA患者的斑块主要位于中段和远段(P<0.05)。结论128层CT血管造影可较好地检出MB-MCA,且主要好发于LAD,以浅表型更为多见。但MB-MCA的形成与冠状动脉硬化无直接联系,当MB出现收缩和功能血流减少的时候可能会导致冠状动脉硬化的形成。

Imaging Features of Myocardial Bridge-mural Coronary Artery(MBMCA)in 128-slice CT Angiography and Its Correlation with Coronary Atherosclerosis

Objective To investigate the imaging features of myocardial bridge-mural coronary artery(MB-MCA)in 128-slice CT angiography and its correlation with coronary atherosclerosis.Methods Clinical and imaging data of 126 patients undergoing coronary angiography in our hospital from January to December 2018 were collected.The detection rate of MB-MCA in all patients and its correlation with coronary arteriosclerosis were summarized.Results In the 126 patients,the detection rate of MB-MCA was 65.08%,among which the detection rate of LAD midpiece was the highest,and the superficial type was the most common.CT detection showed that the of proximal arteriosclerotic plaque incidence was the highest in MB-MCA(63.41%,P<0.05).There was no difference in the detection rate between MB-MCA patients who detected plaque(52.22%)and MB-MCA patients who did not detect plaque(45.45%)(P>0.05).And there were no statistically significant in the number of segment involved and the stenosis degree of plaque between MB-MCA patients and patients without MBMCA detected by CT(P>0.05).However,the detected plaques in patients who detected MB-MCA were mainly distributed in the proximal segment of arteries.The plaques of patients who did not detected MB-MCA were primarily located in the middle and distal segments(P<0.05).Conclusion 128-slice CT angiography can detect MB-MCA better,which mainly occurs in LAD,is more common in superficial type.However,the formation of MB-MCA is not directly related to coronary arteriosclerosis.When MB shrinks and functional blood flow decreases,it may lead to coronary arteriosclerosis formation.