多层螺旋CT对载心肌桥冠状动脉整体形态的研究

目的探讨壁冠状动脉于舒张中、晚期的显示规律,并分析壁冠状动脉于舒张早、中期的狭窄程度与载MB冠状动脉整体形态等的相关关系。方法对1247例临床疑似冠心病患者进行冠状动脉CT成像,在独立工作站上进行多平面重组(MPR,包括CPR),观察血管与心肌的空间关系,确认完全性心肌桥,并对壁冠状动脉的形态进行判断:在MPR像上观察冠脉全程走行,并进行分组。在血管腔内重组成像中测量壁冠状动脉的狭窄程度,并进行两组间t检验。结果在总计1247例受检者中发现完全性心肌桥81例,84处。按照MB近、远端血管形态可分为两组:正常组和迂曲成角组。两组间t检验结果有显著统计学差异(P<0.05)。即载MB冠状动脉走行迂曲成角时,舒张期MCA狭窄程度较走行正常者严重。选取38例分析其静态心电图,迂曲成角组所占比例为61.1%(11/18例),明显高于正常组的30.0%(6/20例),有明显心绞痛症状者中,迂曲成角组所占比例为50.0%(9/18例),亦明显高于正常组的25.0%(5/20例)。结论舒张期MCA狭窄程度与载MB冠状动脉整体走行有关,迂曲成角组舒张期狭窄程度大于正常组,且前者临床症状更重。

Objective To study the mural coronary artery in the diastolic,the late display of law and analyze the mural coronary artery in the diastolic early and mid-coronary artery stenosis degree and containing MB and so the correlation between the overall shape. Methods For 1247 cases of clinical coronary heart disease in patients with suspected coronary CT imaging,in a separate workstation on the multiplanar reformation （MPR,including CPR）,observation of blood vessels and heart muscle spatial relationships,confirm complete myocardial bridge,and coronary wall morphology of the arteries to determine：In the MPR,as observed on coronary full Traveling and grouping. In the vascular wall cavity re-imaging measurements of coronary artery stenosis and conducted t tests between the two groups. Results In a total of 1247 cases of subjects found in 81 patients with complete myocardial bridge,84. Accordance with the MB proximal and distal vascular morphology can be divided into two groups：normal group and tortuous angulation group. T test results between the two groups statistically significant difference （P0.05）. That is contained MB tortuous coronary Traveling into the corner when the diastolic MCA stenosis is higher than normal Traveling serious. Select the 38 cases of analysis of their static electrocardiogram,tortuous into a corner group the proportion of 61.1% （11/18 cases）,significantly higher than the normal group 30.0% （6/20 cases）,there are clear symptoms of angina pectoris,tortuous angled group the proportion of 50.0% （9/18 cases）,was also significantly higher than the normal group 25.0% （5/20 cases）. Conclusion Diastolic MCA stenosis and coronary artery containing the overall Traveling MB related to diastolic tortuous angulated stenosis group than the normal group,and the former is more emphasis on clinical symptoms.