64层螺旋CT图像融合技术在诊断冠状动脉起源、走行中的价值

目的：探讨64层螺旋CT图像融合技术在诊断冠状动脉起源、走行中的价值。方法：回顾性分析2006年8月8日至2007年9月30日行冠状动脉64层螺旋CT血管造影检查患者的结果，共326例，包括1例冠状动脉搭桥术后患者。对每位患者图像行容积重现（VR）法重建心脏及冠状动脉树，二者图像融合，透明化处理，分别观察冠状动脉主干及分支起始部位、走行分布情况。结果：共326例冠状动脉各段及其与心脏关系清楚显示，冠状动脉起源正常313例（96．0％），冠状动脉起源异常共13例（4．0％）。右冠状动脉（RCA）开口于主动脉右窦上方1例，右圆锥支（CB）开口于主动脉右窦1例。左冠状动脉主干（LM）开口于主动脉左窦上方5例，左冠状动脉前降支（LAD）及回旋支（LCX）分别开口于主动脉左窦2例，左侧圆锥支（LCA）开口于主动脉左窦2例，左旋支开口于主动脉右窦1例。另有1例为冠状动脉搭桥术后桥血管开口于主动脉升部前壁和乳内动脉．并可见侧支循环动脉。循环类型呈右冠优势型311例（95．4％），均衡型6例（1．8％），左冠优势型9例（2．8呦。结论：64层螺旋CT图像融合技术显示冠状动脉与心脏关系直观、准确，在诊断冠状动脉起源、走行中有重要价值。

THE APPLICATION OF 64-SLICE CT MERGE VIEW TECHNIQUE IN DIAGNOSIS OF CORONARY ARTERY ORIGINATION AND TRAVELING COURSE

Objective：To discuss the clinical application of 64-slice CT merge view technique in diagnosis of coronary artery origination and its course. Methods：64-slice CT coronary artery angiography data of 326 patients from August 8,2006 to September 30,2007 were analyzed retrospectively. Volume rendering （VR） was used to reconstruct the heart and coronary artery tree, then they were merged and transparentized to observe the orignation and distribution of coronary artery. Results：The normal origination was found in 313 cases （96.0%）,the anomalous origination was found in 13 cases（4.0%）. Right coronary artery（RCA） came from the upper part of fight sinus in 1 case. Conus branch （CB） came from right sinus in 1 case. Left coronary arteries main （LM） came from the upper part of left sinus in 5 cases. The left anterior descending（LAD） and the left circumflex （LCX） originated from left sinus in 2 cases.Left conus arteries （LCA） came from left sinus in 2 cases,LCX originated from fight sinus in 1 case. Left and right coronary artery bypass grafts originated from the anterior wall of ascending aorta and arteriae mammaria interna in 1 case, it had collateral circulation.The circulation type of RCA predominated in 311 cases （95.4%）,balanced circulation type in 6 cases（1.8%）,left coronary artery predominated in 9 cases （2.8%）.Conclusion：64-slice CT merge view technique directly and accuratly demonstrates the relationship of coronary artery and heart. It has significant applicative value for diagnosis in coronary artery origination and traveling course.