64排螺旋CT冠状动脉成像诊断心肌桥-壁冠状动脉的价值

目的 探讨64排螺旋CT(64-MSCT)冠状动脉造影(CCTA)技术在冠心病诊断中对心肌桥-壁冠状动脉(MB-MCA)的检出率及应用价值.方法 回顾性分析332例临床怀疑或确诊冠心病患者的64排螺旋CT冠状动脉造影的检查资料,观察有无心肌桥-壁冠状动脉.结果 64排螺旋CT冠脉造影共检出心肌桥-壁冠状动脉63例,检出率18.9％,其中59例(93.6％)单发心肌桥-壁冠状动脉,4例(6.3％)多发心肌桥-壁冠状动脉;发生于前降支最为多见,为53例(76.8％).心肌桥长度5～68 mm,厚度1.5～5.0mm,其中39例载心肌桥-壁冠状动脉近或远段血管伴有不同程度的粥样硬化斑块,管腔狭窄率＜50％共30例.结论 64排螺旋CT冠脉造影是一种诊断心肌桥-壁冠状动脉的可靠、无创的方法,尤其可以显示其MSCT的表现特点,载支血管粥样硬化狭窄情况,为临床提供明确直观的诊治信息.

Diagnostic value of 64-slice spiral CT coronary angiography in myocardial bridging-mural coronary artery

Objective To investigate the application value of 64-slice spiral CT (64-MSCT) coronary angiography (CCTA) in the diagnosis of coronary heart disease and the detection rate of myocardial bridgingmural coronary artery (MB-MCA).Methods Examination data of 64 slice spiral CT coronary angiography for 332 cases of clinically suspected or confirmed patients with coronary heart disease was retrospectively analyzed,observed that there was MB-MCA or not.Results MB-MCA was detected in 63 cases,with the detection rate of 18.9％,in whom there were 59 cases (93.6％) of single MB-MCA and 4 cases (6.3％) of multiple MB-MCA;MB-MCA occurred in anterior descending branch in 53 cases (76.8％),which was the most common.The length of myocardial bridge was 5-68 mm,the thickness of 1.5-5.0 mm,different degree of atherosclerotic plaque occurred in 39 cases of proximal or distal blood vessels with MB-MCA,there were 30 cases with the lumen stenosis rate lower than 50％.Conclusion 64 slice spiral CT coronary angiography is a reliable and noninvasive diagnostic method for MB-MCA,which can display the features of MSCT and atherosclerotic stenosis of carrying vessel,provide clear and intuitive help for clinical diagnosis and treatment.