多层螺旋CT诊断成人先天性冠状动脉畸形的临床价值

Clinical values of multi-slice spiral CT angiography in detection of congenital coronary anomalies in adults

目的分析多层螺旋CT诊断成人先天性冠状动脉畸形(CCA)的临床价值。方法回顾性分析300名行多层螺旋CT冠状动脉成像(MSCTA)的资料,探讨冠状动脉的起源、走行和终止情况,统计成人先天冠状动脉畸形(CCA)的发生率及CT表现。结果300例中,检出各类CCA共84例,检出率为28.0%,其中起源异常11例,检出率3.7%;冠状动脉结构异常71例,心肌桥(MB)67例,检出率为22.3%,回旋支发育异常4例,检出率1.3%;冠状动脉终止异常2例,均为冠状动脉瘘,检出率0.7%。结论MSCT能够准确地显示冠脉起源、结构和终止异常,对成人冠状动脉畸形的诊断和预后判断有重要的临床应用价值。

Objective To study the diagnosis of congenital coronary anomalies （CCA） in adults with MSCTA （Multislice Spiral Computed Tomography angiography）.Methods Three hundred patients with suspected coronary artery disease were referred to undergo MSCTA.The origin,course and termination of coronary arteries were analyzed and the prevalence of CCA in adults was recorded.Results A total of 84 cases of CCA were found in the 300 patients who underwent MSCTA,giving the detection rate of 28.0% （84/300）,including anomalies of origin in 11 patients （3.7%,11/300）,myocardial bridge in 67 patients （22.3%,67/300）,hypoplasia of left circumflex artery in 4 patients （1.3%,4/300）,and abnormal termination in two patients （0.7%,2/300）.Conclusion MSCTA can be used to confirm the presence of the origin,course and termination of anomalous coronary arteries and has an important clinical significance in the diagnosis of CCA in adults.