电子束CT技术诊断冠状动脉瘘的临床应用价值

目的 探讨冠状动脉瘘的电子束CT（EBCT）征象。方法 对经EBCT工手术证实的10例冠状动脉瘘行回顾性分析。本组男7例，女3例，年龄2岁至55岁，中位年龄为48岁。EBCT检查均采用单层增强扫描。结果 EBCT提示6例右侧冠状动脉扩张迂曲，其中5例与扩大的心室腔沟通，另1例近段与主肺动脉沟通；4例冠状动脉瘘源于左侧冠状动脉，其中1例左侧对角支粗大，局部囊状扩张钙化，与左室腔沟通，2例左侧圆锥支与主肺动脉连接，最后1例左侧冠状动脉主干及回旋支扩张钙化，后者经左房前间隙经后壁与右房沟通。结论 EBCT提示冠状动脉及其分支扩张迂曲，与心腔或其他血管异常沟通，应首先考虑冠状动脉瘘。

Electron beam CT diagnosis of coronary artery fistula: the clinical values

Objective To study the electron beam CT (EBCT) findings of coronary artery fistula. Methods EBCT findings of 10 cases of coronary artery fistula proved by surgery were studied retrospectively. The series included 7 male and 3 female patients, aged from 2 to 55 years (48 years in average) . Enhanced scan in single slice mode was performed. Results EBCT revealed dilated and tortuous right coronary artery in 6 patients out of 7. Among those 6 patients a communication between the right coronary artery and the enlarged ventricular cavity was detected in 5 patients, while in the rest patient the proximal right coronary artery was connected with pulmonary trunk. EBCT revealed that coronary artery fistula was from the left coronary artery in 4 patients. In a case, the left dilated and calcified diagonal branch was communicated to the left ventricle. The left conical branch connected with pulmonary trunk in 2 cases. In another case the dilated and calcified major left coronary artery and its circumflex branch were revealed, and the latter went across the pre - left atrial space into the the right atrim through the posterior wall. Conclusion Coronary artery fistula is the first consideration when EBCT demonstrates an abnormal communication between the dilated and tortuous coronary artery or its branch and cardiac chamber or blood vessel.