64排螺旋CT对冠状动脉起源变异的诊断作用

Application of 64-slice spiral CT in detection of anomalous origin of coronary arteries

目的探讨64排螺旋CT在冠状动脉变异诊断的价值。方法回顾性分析306例行64排螺旋CT冠状动脉造影成像(CTA)结果,冠状动脉起源变异9例,发生率3.4%。用多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)等重建方法评价变异冠状动脉的行径及其与临近大血管的关系,用仿真内镜(CTVE)评价异位开口及其与临近冠状动脉开口的关系。结果冠状动脉起源变异9例中,右冠(RCA)开口于左冠窦2例,RCA开口于前降支(LAD)1例,RCA开口高位2例,LAD与回旋支(LCX)分别开口于左冠窦2例,LCX开口于右冠窦1例,LCX开口于右冠主干1例。结论64排螺旋CT扫描及重建技术能清晰显示冠状动脉开口及冠状动脉全貌,可作为诊断冠状动脉变异的可靠手段。

Objective To explore the valuation of diagnosing anomalous origination of coronary arteries performed with 64-slice spiral CT. Method The 306 cases who underwent CTA were analyzed retrospectively. Multi-planar reconstruction （MPR）, maximum intensity projection （MIP）, volume rendering （VR） were used to observe the course of anomalous coronary arteries and to study its relationship with nearby rasculars, CTVE was used to demonstrate the anomalous origin of coronary arteries,and the relationship with the origins of other coronary anteries. Results Nine cases （3.4%） of coronary arteries with anomalous origins were demonstrated in the 306 cases. The coronary anomalous origins included 2 cases of RCA from lift coronary sinus,case of RCA from LAD respectively, 2 cases of RCA with high location in right sinus, 2 cases of demonstrated separate origins of the LCX and LAD from the left sinus of valsalva,1 case of LCX from right sinrs,1 case of LCX from right coronary artery main segments. Conclusion The coronary origin and course could be demonstrated clearly on 64-slice CT scan and anglo-restruction,which is valuable to cardiologists.