64MSCTA对冠状动脉变异的诊断及临床评价

目的评价64层螺旋CT冠状动脉血管成像（CTCA）对冠状动脉变异的诊断价值及临床评价。方法回顾性分析3529例临床疑为心肌缺血患者及常规体查者冠状动脉CTA影像检查结果并对发现的变异冠状动脉进行分类。结果3529例冠状动脉CTA受检者中，共检出冠状动脉变异42例（1．19％，42／3529），MIP、VRT、CPR重建图像均明确显示其开口及走行；其中右冠状动脉起自主动脉左冠状窦者9例，左冠状动脉起自主动脉右冠状窦者2例，左回旋支异位开口于右冠窦1例，冠状动脉高位开口于升主动脉壁者6例．并行左主干3例（前降支、旋支分别开口于左冠窦），左主干开口于肺动脉伴右冠状动脉瘤1例，左旋支-冠状静脉瘘者2例，副冠状动脉9例，右冠状动脉-左心室瘘合并右冠状动脉瘤l例。冠状动脉发育不良8例。结论冠状动脉CTA能准确显示各种类型冠状动脉变异，可作为无创性诊断冠状动脉变异的首选方法。

Diagnostic value of 64-slice spiral CT coronary angiography in patients with coronary artery anomalies

Objective To evaluate the diagnostic value of 64-slice multi-detector row spiral CT coronary angiography in patients with coronary artery anomalies, Methods The value of 04-slice multi-detector row spiral CT angiography in de- tecting coronary artery anomalies in 3529 patients was retrospectively analyzed. Results Thirty-four cases （1. 19%, 42/ 3529） of coronary artery anomalies were detected by 64-sclice multi-detector row spiral CT angiography. The anomalies consisted of 9 cases of right coronary artery originated from left aortic sinus, 2 cases of left coronary artery originated from right aortic sinus, 1 case of left circumflex artery originated from right aortic sinus, 6 cases of right coronary artery with high take-off origin, 3 cases of multiple coronary ostia, 1 case of left coronary artery originated from pulmonary artery with RCA aneurysm, 2 cases of LCX-CV fistula, 9 cases of bilateral coronary, 1 case of RCA-LV fistula with RCA aneu- rysm, and 8 cases of coronary artery dysplasia. Conclusion 64-slice multi-detector row spiral CT coronary angiography can accurately evaluate coronary artery anomalies and show details of different types of anomalies. It is recommended as the first-line non-in.vasive method for diagnosing coronary artery anomalies.