双源CT冠脉成像对冠状动脉畸形的诊断价值

目的：探讨双源CT（DSCT）冠脉成像在冠状动脉畸形（CAA）诊断中的价值。方法：回顾分析357例经DSCT冠脉成像检出的冠状动脉畸形患者的MPR、VR、MIP及CPR图像，其中31例患者的图像与常规冠状动脉血管造影（CAG）进行对照。结果：DSCT冠脉成像检出的357例冠状动脉畸形中，冠状动脉起源异常37例，包括冠状动脉高位起源15例，冠状动脉起源于对侧冠状窦13例，回旋支起自左冠状窦7例，回旋支起自右冠状窦1例，单一冠状动脉1例；本组冠状动脉走行异常均表现为心肌桥（MB），其发现MB319例326处；冠状动脉终止异常中冠状动脉瘘1例。其中31例于DSCT冠脉造影后行CAG检查，DSCT冠脉成像检出27例29处MB者CAG仅检出21例22处，但3例冠状动脉起源异常及1例冠状动脉瘘行CAG全部检出。结论：DSCT冠脉成像能清晰地显示各种冠状动脉畸形，为术前评估及预后判断提供重要信息，亦可作为随诊复查的可靠方法。

Diagnostic Value of Dual - source CT Coronary Angiography in Coronary Artery Anomalies

Objective： To investigate the diagnostic value of dual - source CT （DSCT） coronary angiog- raphy in coronary artery anomalies （CAA）. Methods：Dual -source CT coronary angiography images and multi - planar reconstruction （MPR） , volume render （VR） , maximum intensity projection （MIP） , curved - planar reconstruction （CPR） images of 357 patients with CAA were retrospectively analyzed. Conventional coronary artery angiography （CAG） was performed in 31 patients. Results：357 cases of CAA were detected by DSCT coronary angiography, including 37 cases of anomalous origin of coronary artery（ 15 with high origin of coronary artery , 13 with coronary artery originated from the opposite sinus, 7 with LCX originated from left coronary si- nus, 1 with LCX originated from right coronary sinus, 1 with single coronary artery） , 319 cases of abnormal course with 326 lesions of myocardial bridge（ MB）, 1 case of abnormal termination with coronary artery fistulas ~ CAG was performed after DSCT coronary angiography in 31 patients. Among the 27 patients with 29 MB on DSCT coronary angiography, only 21 patients with 22 MB were detected on CAG. All the 3 cases of anomalous origin and 1 case of coronary artery fistulas with DSCT coronary angiography performed were detected on CAG. Conclusions： Dual - source CT coronary angiography can dearly display all kinds of CAA, and it can provide important information for prognosis and operation. It should be selected as the reliable method for follow - up survey.