选择性冠状动脉造影与多层螺旋CT对冠状动脉高位开口畸形诊断价值的比较

Comparison of selective coronary artery angiography and multislice computed tomography in diagnosis of high take-off coronary anomaly

目的比较选择性冠状动脉造影(CAG)与多层螺旋CT(MSCT)对冠状动脉高位开口(HTO)的诊断价值。方法对疑为冠状动脉畸形的患者进行回顾性研究。将研究对象分为两组:CAG组8324例,均行CAG;MSCT组1352例,均行MSCT检查。评价HTO的发生率和相关临床因素。结果两组间性别构成、年龄及有高血压、糖尿病、吸烟史患者的构成比的差异均无统计学意义(P值均>0.05)。CAG组的HTO检出率为0.2%(17/8324),显著低于B组的1.7%(23/1352,P<0.0001)。结论 MSCT用于诊断HTO比CAG更为有效,且可评价冠状动脉近段是否被大血管压缩。

Objective To compare the values of the selective coronary artery angiography （CAG） and the multislice computed tomography （MSCT） in diagnosis of the high take-off （HTO） coronary anomaly. Methods We retrospectively studied the patients who were suspected of coronary anomaly. Group CAG consisted of 8 324 cases receiving selective CAG; Group MSCT consisted of 1 352 cases receiving cardiac MSCT. The incidences of HTO coronary anomaly and its associated clinical factors were evaluated. Results There were no significant differences in sex, age, hypertension history, smoking or diabetes history between the two groups. Seventeen HTO cases were detected among 8 324 cases in group CAG and 23 cases were detected among 1 352 cases in MSCT group; the incidence of HTO was 0.2 % （17/8 324）in Group CAG, which was significantly lower than that in MSCT group （1.7 % [23/1 352]） （ P〈0. 000 1）. Conclusion MSCT coronary angiography is more effective then selective CAG in depicting HTO coronary anomaly, and MSCT can also be used to detect whether the proximal coronary artery is compressed by great arteries or not.