64排探测器CT冠状动脉成像对心肌桥伴冠心病的诊断价值探讨

Diagnositic value of 64 multi-detector rows CT coronary angiography in myocardial bridge and coronal artery disease

目的:探讨64排探测器CT(MDCT)对心肌桥伴冠心病的诊断价值及临床意义。方法:对217例拟诊冠心病(CAD)患者行64MDCT冠状动脉血管成像(CCTA),根据CCTA上冠状动脉的走行部位,诊断47例心肌桥,测量心肌桥的长度、厚度,分析各支粥样斑块性质和狭窄程度,判断血管硬化与心肌桥的关系。结果:64MDCTA发现心肌桥51处/47例,检出率为21.66%;34例位于左前降支中段(66.67%),肌桥长度为5.6～27.6mm;厚度为0.52～4.8mm;其中22例伴有不同程度的粥样硬化斑块,管腔狭窄<50%者19例。结论:64MDCT冠脉成像可无创性检出心肌桥,显示其MDCT表现特点、邻近血管硬化狭窄等,可为临床治疗提供有价值的信息。

Objective： To explore the diagnostic value of 64 MDCT coronary angiography in myocardial bridge and coronary artery diseases （CAD）. Methods： 217 suspects of CAD were examined by 64 MDCT coronary angiography. Forty-seven patients were diagnosed with myocardial bridge based on the abnormal course of coronary artery. By measuring the length of mural coronary artery （MCA） and the thickness of myocardial bridges （MB） and analyzing the characteristic of the main branches of atherosclerosis plaques and the vascular stenosis grade, the relationship of artery atherosclerosis and myocardial bridge was decided. Results： 51 sites of myocardial bridge in 47cases were found by 64 MDCTA, with the positive rate of 21.66%. 34 sites of the myocardial bridges located at the middle segment of anterior descending artery （66.67%）. The length of MCA was about 5.6-27.6 mm, and the thickness of it 0.52-4.8 mm; 22 cases had differential grade of atherosclerosis plaques, they scular stenosis of 19 sites was less than 50%. Conclusions： 64 MDCT coronary angiograph can clearly detect the myocardial bridge without invasion, show atherosclerosis stenosis of adjacent arteries, and provide valuable information for clinical diagnosis and treatment.