电子束CT在先天性冠状动脉异常诊断中的临床价值

目的 探讨电子束CT（EBCT）在行天性冠状动脉异常诊断中的临床价值。方法 对EBCT诊断为先天性冠状动脉异常，并有心血管造影和（或）手术结果的20例患者进行回顾性分析。其中16例行心血管造影。男13例，女7例，年龄5个月至70岁，平均15.5岁。除1例行连续容积扫描外，19例采用单层增强扫描，其中1例同时行单层平扫和电影序列，1例加行电影序列。结果 20例中，EBCT提示19例先天性冠状动脉异常征象并做出正确诊断，包括5例起源分布异常、6例单支冠关动脉畸形和8例冠状动脉瘘；造影16例确诊15例。两种诊断方法诊断结果无显著性差异（经γ^2检验，γ^2=0.32，P＞0.05）。结论 EBCT是一种较为理想的无创性诊断冠状动脉先天性异常的方法。

Clinical application of EBCT for evaluation of congenital coronary artery anomalies

Objective　To evaluate the role of electron-beam CT (EBCT)in the diagnosis of patients with congenital coronary artery anomalies. Methods　Twenty patients with angiocardiography and (or) operation outcomes, and diagnosed as congenital coronary artery anomalies by means of EBCT were analyzed retrospectively. 16 patients had angiocardiographic results. The 13 male and 7 female patients ranged in age from 5 months to 70 years (median age was 15.5 years). Continuous volume scan (CVS) was performed on 1 patient, enhanced single slice mode (SSM) were done on 19 patients (95%) including one adding both plain SSM and cine study, and the other adding cine study. Results　EBCT suggested signs of congenital coronary artery anomalies and made correct diagnosis in 19 patients, including 5 patients with anomalous origin and course, 6 patients with single coronary artery and 8 patients with coronary artery fistula. The correct diagnostic rate of EBCT was 19/20, while that of angiocardiography was 15/16. In the Chi square test, χ2=0.32, P>0.05, so that there wasn′t significant difference between them. Conclusion　Because of its remarkable advantage in demonstrating origin, course, and drainage sites of coronary artery anomalies, EBCT is an excellent noninvasive method in the diagnosis of coronary artery anomalies.