双源CT冠状动脉血管成像在心肌桥和壁冠状动脉诊断中的应用

Application of Dual-source CT Coronary Angiography in the Diagnosis of Myocardial Bridge and the Wall of Coronary Artery

目的：探讨双源CT冠状动脉血管成像诊断心肌桥（MB）和壁冠状动脉（MCA）的价值.方法：767例疑冠心病患者行双源CT冠状动脉血管成像,对其中401例诊断为MB-MCA者的CT表现进行回顾性分析,并测量其MB的长度和厚度.其中32例同时在DSA下进行冠状动脉造影（CAG）检查,并用双源CT Inspace软件中的4D工具对所有期相的数据进行动态重组,以电影模式重组和回放,与DSA对照分析两者显示MB-MCA的价值.结果：本组MB-MCA的发生率为52.3%,其中前降支占86.3%,左旋支占9.7%,右冠状动脉最少占1.7%.MB长（20.2±2.3）mm,厚（2.6±0.2）mm.结论：双源CT冠状动脉成像综合各种后处理技术是目前诊断MB-MCA最有价值的无创性检查.

Objective：To investigate the clinical value of dual-source computed tomography coronary angiography （DSCTCA） in the diagnosis of myocardial bridge （MB） and intramural coronary artery （MCA）. Methods：767 cases with potential coronary artery disease underwent the DSCTCA. The CT images from 401 patients who were finally diagnosed as MB-MCA were analyzed retrospectively. The length and thickness of these patients＇ MB were measured. 32 patients with MB-MCA also received coronary arteriongraphy （CAG） by digital subtraction angiography （DSA）. The data in all phases of CAG was restructured dynamically by using the 4D tools of dual-source CT Inspace software, restructured and replayed in the movie mode, and compared with the findings by DSA. Results：The incidence of M B-MCA was 52.3% in this study, amongst which 86.3% occurred in left anterior descending arteries and 1.7% in right coronary arteries. The length with depth of MB were （20.2 ± 2.3 ） mm and （ 2.6 ± 0.2 ） mm, respectively. Conclusions ： At present, combination of DSCTCA with other postprocessing techniques is most effective and atraumatic examination for the diagnosis of MB-MCA Noninvasive diagnosis of MB-MCA.