冠状动脉心肌桥影像及临床研究

目的探讨心肌桥64排螺旋CT冠状动脉成像及冠状动脉造影影像学特点及临床特征。方法回顾性分析256例确诊心肌桥患者的检出率、部位、临床表现、心电图、心脏超声和治疗情况。结果冠状动脉造影检出率为3.96%,64排螺旋CT检出率29.68%;壁血管狭窄率冠状动脉造影为（48.8±21.2）%,64排螺旋CT为（32.6±13.2）%;前降支心肌桥占92%;单纯心肌桥41例（16.02%）,合并冠状动脉粥样硬化或冠心病96例（37.50%）,合并高血压、高血脂或糖尿病97例（37.89%）;心肌桥患者主要表现为胸痛、胸闷、心悸等;心电图表现以非特异性ST-T改变为主,心脏超声收缩功能正常,部分患者舒张功能下降。结论 64排螺旋CT诊断心肌桥优于冠状动脉造影。心肌桥患者多伴有冠心病、高血压等疾病,临床表现多样,治疗以药物为主。

Imaging and clinical study of coronary myocardial bridge

Objective To investigate the imaging characteristics and clinical features of myocardial bridge on 64-slice CT and coronary angiography.Methods The detective rate,location,clinical manifestation,ECG,cardiac ultrasound and therapy were retrospectively analyzed in 256 patients with myocardial bridge.Results The detective rate of coronary angiography was 3.96%,and of 64-slice CT was 29.68% for myocardial bridge.The stenosis rate of mural coronary artery was（48.8±21.2）% on coronary angiography,and（32.6±13.2）% on 64-slice CT.The anterior descending branch bridge accounted for 92%.The simple myocardial bridge occurred in 41 cases（16.02%）,the myocardial bridge combined with coronary atherosclerosis or coronary heart disease occurred in 96 cases（37.50%） and myocardial bridge combined with hypertension,hyperlipemia or diabetes mellitus occurred in 97 cases（37.89%）.The clinical manifestations were chest pain,dyspnea and palpitation.ECG showed non-specificity ST-T change.The ultrasound showed normal in systolic function,and diastolic function decreased in some patients.Conclusion 64-slice CT is superior to coronary angiography in the diagnosis of myocardial bridge.Myocardial bridge patients are always complicated with coronary heart disease or hypertension,with different clinical manifestations,and are mainly treated medicinally.