冠状动脉CT血管成像在自发冠状动脉壁内血肿患者随访中的应用

目的:探讨冠状动脉(冠脉)CT血管成像(CTA)在自发冠脉壁内血肿患者随访中的应用价值.方法:选择复旦大学附属中山医院心内科2015年1月1日至2018年12年31日收治的接受冠脉CTA复查的10例自发冠脉壁内血肿患者.对比初始冠脉造影和随访冠脉CTA影像,测量病变处冠脉管腔直径并进行比较.结果:10例患者共有11根冠...

Application of coronary computed tomographic angiography in follow-up of patients with spontaneous coronary intramural hematoma

Objective: To explore the value of coronary computed tomographic angiography (CCTA) in follow-up of patients with spontaneous coronary intramural hematoma (SCIH).Methods: From 2015 to 2018, ten patients with SCIH were selected from the Department of Cardiology, Zhongshan Hospital, Fudan University. The initial coronary angiography and follow-up CCTA images were compared, and the coronary vessel lumen diameter at the lesion was measured and compared.Results: Ten patients with eleven affected coronary arteries were included. The left anterior descending coronary artery with type 2 SCIH was the most common target. The average diametes of the proximal and distal segments of the lesions were (1.54±0.18) mm and (0.78±0.17) mm, respectively. Six patients were given conservative treatment, and percutaneous coronary intervention with stent implantation was performed in four patients. None of the ten patients had chest tightness or chest pain after discharge. The average follow-up time of CCTA was (8.2±5.2) months. The coronary arteries recovered entirely without any coronary dissection or intramural hematoma in 6 patients stents were unobstructed without restenosis or hematoma in 4 patients. The mean diameter of the proximal segment of previous lesions with and without stent implantation was (3.33±0.58) mm and (2.60±0.14) mm, respectively. The mean diameter of the distal segment of previous lesions was (1.59±0.30) mm. But the ending and side branches of affected coronary arteries were invisible in CCTA.Conclusions: CCTA is the preferred follow-up method for SCIH patients, but it cannot completely and clearly display the ending segment and fine branches of coronary artery.