多层螺旋CT诊断冠状动脉起源异常的价值

目的探讨多层螺旋CT(MSCT)对冠状动脉起源异常的诊断价值。方法2001—2005年,5000例临床可疑或诊断冠状动脉疾病的患者接受冠状动脉MSCT检查(0·5s螺旋扫描,回顾性心电门控技术,单或双扇区重建算法,0·625mm或1·25mm层厚,250mm显示野,512×512矩阵,经肘部静脉注射对比剂),对左、右冠状动脉CT图像进行重组。结果MSCT检出冠状动脉起源异常39例(0·78%),其中右冠状动脉高位开口20例,冠状动脉起源于对侧冠状窦或冠状动脉16例(右冠状动脉起源于左冠状窦11例,左回旋支起源于右冠状动脉或右冠状窦3例,右冠状动脉起源于后冠状窦1例,左冠状动脉主干起源于后冠状窦1例),单一冠状动脉2例(单一左冠状动脉和单一右冠状动脉各1例),左前降支和左回旋支单独起源于左冠状窦1例。结论MSCT能够用于冠状动脉起源异常的诊断。

Value of multislice spiral CT in the diagnosis of anomalous origin of the coronary arteries

Objective To investigate the value of multislice spiral CT (MSCT) coronary angiography in the diagnosis of anomalous origin of coronary arteries. Methods 5000 patients diagnosed or suspected as with diseases of coronary artery underwent MSCT coronary angiography (retrospectively ECG-gating; 0.5 s rotation; one-sector or two-sector reconstruction algorithm; intravenous contrast agent) 2001~2005. Results Anomalous origin of coronary artery was incidentally found with multislice spiral CT in 39 patients (0.78%), including anomalously high origin of the right coronary artery (n=20), anomalous origin of the right coronary artery from left coronary sinus (n=11), aberrant circumflex artery arises from the right coronary sinus or right coronary (n=3), anomalous origin of the right coronary artery from the posterior coronary sinus (n=1), anomalous origin of the left coronary artery from the posterior coronary sinus (n=1), single coronary artery (n=2), separate origin of circumflex and left anterior descending arteries from left coronary sinus (n=1). These signs were better shown by MSCT coronary angiography. Conclusion MSCT coronary angiography is a useful adjunctive technique to invasive coronary angiography in the diagnosis of anomalous origin of coronary arteries.