成人冠状动脉瘘的CT血管成像特点

目的 探讨冠状动脉瘘(CAF)的CT血管成像特征。方法 分析45例接受DSCT (31例)及256 iCT(14例)成像CAF患者的图像质量、辐射剂量及影像学特征。结果 45例CAF患者的CTCA图像质量均满足诊断需要,平均有效剂量为(12.92±3.73)mSv。CAF起自左冠状动脉23例、右冠状动脉13例、起自两者7例,起自右冠状动脉及支气管动脉1例,起自右冠状动脉及头臂干1例。CAF单一瘘管33例,多发瘘管12例。瘘入右心系统共40例,其中瘘入肺动脉31例、冠状窦4例、右心房3例、右心室1例、上腔静脉1例;瘘入左心系统5例,其中瘘入左心房2例、左心室2例、肺静脉1例。瘘血管可有纡曲、血管丛样、扩张或动脉瘤形成等表现。结论 CTCA检查可无创、准确地显示CAF的部位、走行及并发畸形,可作为临床诊断CAF的首选检查方法。

Morphologic features of adult coronary artery fistula with CTA

Objective To analysis the morphology features of coronary artery fistula (CAF) with multi-detector CT coronary angiography (CTCA). Methods Totally 45 patients with CAF underwent CTCA (DSCT 31 cases vs 256 iCT 14 cases). Images quality, radiation doses and morphology features of CAF patient were analyzed. Results The image quality of 45 CAF patients met the diagnostic needs. The average effective radiation dose was (12.92±3.73)mSv. 23 cases CAF arose from the left coronary artery, 13 cases arose from the right coronary artery, 7 cases arose from both, 1 case arose from the right coronary artery and bronchial artery and 1 case arose from the right coronary artery and the brachiocephalic. CAF had single fistula vascular in 33 cases, multiple fistulas in 12 cases. 40 cases CAF drainaged into the right heart system, of which 31 cases into pulmonary artery, 4 cases into coronary sinus, 3 cases into the right atrium, 1 case into right ventricle, 1 case into superior vena cava. 5 cases CAF drainaged into the left heart system, of which 2 cases into the left atrium, 2 cases into the left ventricular, 1 case into the pulmonary vein. Fistula vascular manifested as tortuosity vascular, vascular plexus, expansion or aneurysm formation. Conclusion CTCA can noninvasively and accurately show the site of CAF, traveling and concurrent deformities, can be used as the preferred screening method in clinical diagnosis of CAF.