64层螺旋CT对先天性冠状动脉异常起源的显示

目的总结冠状动脉异常起源的螺旋CT影像表现。方法回顾性分析2005年5月1日-2006年5月1日行冠状动脉检查的患者的CTA结果,共2274人,其中冠状动脉异常起源者共24例,发生率为1.06%。其中男22例,女2例,年龄36~79岁,平均52.8岁。对患者图像分别行多平面重建(MPR)、最大密度投影(MIP)和容积重现(VR)法重建图像。结果右冠状动脉开口于左冠窦6例,开口高位5例;左主干开口高位4例,开口于左冠窦后缘2例;左前降支与左回旋支分别开口于左冠窦5例;左回旋支开口于右冠窦1例;左右冠状动脉共干1例。所有图像通过不同的重建方法可以清晰直观地显示异常血管的起始和行程。结论64层螺旋CT可清晰显示冠状动脉异常起源及行程异常,可为心血管医生提供有价值的影像。

Identification of anomalous origin of coronary arteries in adults with 64-slice spiral CT

Objective To summarize the appearance of anomalous origination of coronary arteries performed with 64-slice spiral CT. Methods From May 1, 2005 to May 1, 2006, 2 274 cases who underwent CT angiography were analyzed retrospectively. Coronaries with anomaly origins were demonstrated in 24 cases (1.06%, 22 males and 2 females, average age 52.8 years old with range 36-79 years old). Multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) were used to demonstrate the origin and course of the coronary arteries. Results The coronary anomalous originations included 5 cases of right coronary arteries (RCA) with high location in right sinus, and 6 cases of RCA from the left coronary sinus. High locations of left main () segments from left sinus of Valsalva were seen in 4 cases, and 2 cases from posterior left sinus. Five cases demonstrated separate origins of the left circumflex (LCx) and left anterior descending (LAD) from the left sinus of Valsalva. One LCx artery origin from the right sinus of Valsalva was shown, while one case of shared a common trunk with RCA. Conclusion The coronary anomalous origins and courses could be demonstrated clearly on 64-slice CT angiography, which is valuable to cardiologists.