MSCT血管成像在儿童冠状动脉起源异常诊断中的应用价值

Application value of MSCT angiography in the anomalous origin of coronary artery in children

目的探讨多层螺旋CT血管成像(MSCTA)在儿童冠状动脉起源异常(AOCA)诊断中的应用价值。方法选取2014年6月至2019年12月河南省儿童医院,郑州大学附属儿童医院,郑州儿童医院行心脏MSCTA检查并确诊28例AOCA患儿,结合多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现(VR)后处理技术分析AOCA变异血管和变异类型。结果按变异血管分类:右AOCA占60.71%,其中右AOCA起源于左冠状动脉窦占47.06%,右AOCA起源于主动脉占41.18%,右AOCA起源于肺动脉占11.76%。左AOCA占39.29%,其中左AOCA起源于主动脉占45.45%,左AOCA起源于肺动脉占27.27%,左回旋支变异占18.18%,左AOCA起源于右冠状动脉窦占9.09%;按变异类型分类:AOCA于主动脉占50.00%,AOCA于对侧冠状动脉窦占32.14%,AOCA于肺动脉占17.86%。结论MSCTA分辨率高、扫描速度快,可直观显示冠状动脉的开口及走行特点,对AOCA的诊断具有非常重要的作用。

Objective To explore the value of of multi-slice spiral CT angiography(MSCTA)in the diagnosis of anomalous origin of coronary artery(AOCA)in children.Method From June 2014 to December 2019,28 children with AOCA were examined by MSCTA in Zhengzhou Children’s Hospital,Zhengzhou University Affiliated Children’s Hospital.Combined with multi-planar reconstruction(MPR),curved planar reconstruction(CPR),maximun internsity projection(MIP)and volume rendering(VR)post-processing technology,AOCA variant blood vessels and variant types were analyzed.Result Classification by vascular variation:60.71%of right AOCA originated from the left coronary sinus,47.06%of right AOCA originated from the left coronary sinus,41.18%of right AOCA originated from the aorta,and 11.76%of right AOCA originated from the pulmonary artery.Left AOCA accounted for 39.29%,among which the left AOCA originated from the aorta accounted for 45.45%,the left AOCA originated from the pulmonary artery accounted for 27.27%,the left cyclotron branch variation accounted for 18.18%,and the left AOCA originated from the right coronary sinus accounted for 9.09%.Classification by type of variation:AOCA accounted for 50.00%in the aorta,32.14%in the contralateral coronary sinus,and 17.86%in the pulmonary artery.Conclusion MSCTA has high resolution,fast scanning speed,and can directly display the characteristics of coronary artery opening and walking,which plays an important role in the diagnosis of AOCA.