64层螺旋CT对壁冠状动脉形态学的研究

Morphological Study of Myocardial Bridge and Mural Coronary Artery by 64-slice CT and Evaluation of Its Clinical Relevancy

目的:探讨心肌桥-壁冠状动脉(myocardial bridge and mural coronary artery,MB-MCA)邻近血管折曲成角改变与壁冠状动脉长度、深度的关系,以及MB-MCA形态学与临床的相关性。方法:回顾性分析93例行64层螺旋CT冠状动脉CTA检查发现MB-MCA的患者(部分病例同时行冠状动脉血管造影检查),测量壁冠状动脉的长度、深度,分析其与邻近血管折曲成角改变的关系及与临床的相关性。结果:MB-MCA邻近段常有折曲成角改变62.2%(61/98),其与壁冠状动脉的深度无相关性,与壁冠状动脉的长度呈负相关(P<0.01);单纯性心肌桥症状的有无与壁冠状动脉的深度、长度、邻近段折曲改变均无相关性。结论:MB-MCA邻近段的折曲成角改变对长度较短的壁冠状动脉的存在有提示作用,此特点有利于64层螺旋CT提高对MB-MCA的诊断准确性。

Purpose：To study the relevancy between tortuousness of vessels proximal or distal to myocardial bridge and mural coronary artery （MB-MCA） and the length,depth of MCA.And to evaluate the clinical relevancy of morphology of MB-MCA.Methods：Ninety-three patients with MB-MCA were evalated retrospectively by 64-slice CT（part of cases underwent coronary angiography）. The length and depth of MB-MCA were measured and its relationship with tortuousness of proximal or distal vessels and clinical relevancy was studied.Results：The proximal or distal vessels to MB-MCA showed tortuousness in 62.2% cases （61/98）. It was not relevant with the depth of MCA and negative relevant with the length of MCA （P〈0.01）. The clinical symptoms were not relevant with either the length and depth of MCA or tortuousness of proximal or distal vessels in patients with isolated MB. Conclusion：The tortuousness of proximal or distal vessels may indicate the presence of short MCA. Hence,the recognition of it may improve the diagnostic accuracy of MB-MCA by 64-slice CT.