冠状动脉造影与多层螺旋CT冠脉成像在心肌桥诊断中的价值

Value of coronary angiography and multi-slice coronary CT angiography in diagnosticating myocardial bridge

目的:探讨多层螺旋CT冠脉成像(CCTA)与冠状动脉造影(CAG)在心肌桥(M B)诊断中的价值。方法:回顾性分析疑诊冠状动脉疾病的406例均进行CCTA和CAG检查者,两组采用双盲法CCTA和CAG分别独立阅片,由2名有经验的放射科医生与2名有经验的心内科介入医生采用单盲法阅片,经讨论后共同给出诊断。相互参照另一种检查结果后再次阅片,2次检出率,应用χ2统计分析方法,判断2种方法发现M B有无差异。结果:双盲法CCTA发现M B 19例26段,CAG发现5例5段(P<0.01),差异有统计学意义。相互对照后再次评价,CCTA发现M B数量同前,CAG新发现3例,将新检出的3例患者行腺苷负荷核素心肌显像,相应节段心肌出现心肌低灌注,位置与CCTA一致,共检出8例,2种方法差异有统计学意义(P<0.05)。结论:CCTA对M B和壁冠状动脉显示清晰,较CAG有更高的检出率,容易发现M B,有着特殊的临床诊断价值。

Objective：To investigate the diagnostic value of multi-slice coronary CT angiography（CCTA） and coronary angiography（CAG） in determining myocardial bridge（MB）.Methods：Four hundred and six patients suspecting coronary heart disease the CCTA and CAG were performed for the coronary imaging.The MBs were identified on the CCTA and CAG by radiologists and cardiologists separately and independently before and after consulting each other.The data was statistically analyzed using X-squrae test.Results：Before consulting each other,19 MB in CCTA and 5 MB in CAG were detected by radiologists and cardiologist separately and independently with significant difference statistically（χ^2=8.42,P0.01）.After consulting results each other,same 19 MBs of CCTA and another 3 MBs of CAG were detected by radiologist and cardiologists and difference is significant statistically（χ^2=4.64,P0.05）.Conclusion：CCTA is outperformed the CAG in detecting MB.