冠状动脉CT成像对心肌桥的诊断价值

目的 探讨冠状动脉CT成像对心肌桥的诊断价值.方法 收集214例冠状动脉病变患者的CT检查数据及临床资料.分析心肌桥的检出率,观察肌桥位置,测量肌桥长度,分析壁冠状动脉类型,再根据有无心肌桥分组分析比较粥样斑块的特性.结果 全部病例检出心肌桥81例,检出率为37.85％,肌桥分布左前降支80例,中间支l例,均为单支单段血管受累.左前降支近段心肌桥8例,中段肌桥67例,远段肌桥5例,肌桥平均长度（19.3 ±8.9）mm,肌桥的长度与发生位置无相关（P＞0.05）.壁冠状动脉类型以表浅型多见.伴有心肌桥的左前降支近段血管检出斑块35处,远段2处.合并有心肌桥的左前降支近段血管易形成粥样斑块（P＜0.05）,但斑块性质、长度、管腔狭窄程度与肌桥无相关性（P＞0.05）.结论 心肌桥以左前降支中段好发,多为表浅型,肌桥的长度与发生位置无相关性;伴有心肌桥的左前降支近段血管易形成粥样斑块,但斑块的性质、长度、管腔狭窄程度与肌桥无相关性.冠状动脉CT成像对心肌桥的诊断有重要价值.

The value of coronary artery CT imaging in the diagnosis of myocardial bridge

Objective To explore the value of coronary artery CT imaging in the diagnosis of my- ocardial bridge. Methods 214 cases of coronary artery CT imaging data and clinical data were collected. Detection rate of myocardial bridge was analyzed, location and length of myocardial bridge were deter- mined, the type of mural coronary artery was analyzed, and characteristics of atherosclerotic plaques in both groups with and without myocardial bridge were compared. Results Of all cases,81 cases were de- tected to have myocardial bridge（37.85% ） and myocardial bridges in 80 cases were located in the left anterior descending branch with one located in the intermediate branch. All of the myocardial bridges were solitary diseases. There were 8,67 and 5 cases of myocardial bridges that were located in the proximal, middle and distal left anterior descending branch,respectively. The mean length of myocardial bridge was （ 19.3 -＋ 8.9）mm and no association between location of myocardial bridge and its length was found（ P 〉 0.05 ）. Mural coronary artery type was mostly seen as superficial type. Myocardial bridge in the left anteri- or descending branch complicated with atherosclerosis was detected in 35 cases and 2 were located in dis- tal segment. Vessels in left anterior descending branch complicated with myocardial bridge were suscepti- ble to atheromatous plaque formation （ P 〈 0.05 ） , but no associations between plaque characteristics, length of plaques, as well as blood vessel stenosis with myocardial bridge were found（P 〉 0.05 ）. Conclu- sion Myocardial bridge often occurs in the left anterior descending branch and mostly belongs to superfi- cial type. There was no association between location of myocardial bridge and its length. Proximal blood vessels in left anterior descending branch with myocardial bridge were susceptible to atheromatous plaque formation, but there were no associations between plaque characteristics, length of plaques, as well as blood vessel stenosis with myocardial bridge. Coronary artery CT imaging has an important value in the diagnosis of myocardial bridge.