128层CT评价壁冠状动脉压缩程度与肌桥长度和厚度的相关性临床价值研究

The study of correlation between the severity of systolic compression of the mural coronary artery and length and depth of myocardial bridge evaluated by 128-slice spiral CT

目的:探讨128层SCT评价壁冠状动脉(MCA)收缩期压缩程度与心肌桥(MB)长度和厚度的相关性。方法:分析冠状动脉MSCT血管成像(MSCTCA)患者580例,观察各支冠状动脉有无MB-MCA发生及位置、发生率。以左前降支(LAD)为研究对象,测量MB长度、厚度及MCA收缩期狭窄程度,且分为轻、中、重度狭窄组,比较各组MB-MCA长度和厚度有无差异。结果:580例中MB-MCA 140例,检出率24.14%,LAD中段104例(74.3%),LAD远段16例(11.4%),钝缘支8例(5.7%),第1对角支7例(5.0%),中间支3例(2.1%),右冠状动脉后降支2例(1.5%)。LAD中MB长度范围8～46 mm,厚度0.7～4.4 mm,平均长度(21.80±5.98)mm,平均厚度(2.15±0.74)mm,平均压缩程度(38.5±19.6)%。MB长度不同组间无差异(P>0.05),MB厚度不同组间有差异(P<0.05);MCA收缩期压缩程度与肌桥厚度呈线性正相关(r=0.408,P<0.05),与肌桥长度无相关性(r=0.076,P>0.05)。结论:128层SCTCA能准确显示MCA与心肌的解剖关系,是诊断MB-MCA的首选方法,且能评价MCA收缩期压缩程度与MB长度和厚度的相关性,为临床提供依据。

Objective： To discuss the correlation between the severity of systolic phase compression of the mural coronary artery （MCA） and length and depth of myocardial bridge （MB） evaluated by 128-slice SCT. Method： 580 cases examined by multi-slice spiral CT coronary artery angiography （MSCTCA） were analyzed to observe the presence, location and occurrence rate of MB-MCA. Taking LAD as the research object, the length and depth of MB, the degree of systolic phase compression of MCA were measured. All the research objects were divided into mild, moderate or severe stenostic groups according to degree of systolic phase compression of MCA, and then the difference in the length and depth of each MB-MCA was compared among groups. Results： 140 MB-MCAs were found in 580 patients, with an incidence rate of 24.14%. 104 lesions （74.3%） were in the middle part of LAD, 16 lesions （11.4%） in the distal part, 8 lesions （5.7%） in obtuse marginal branch, 7 lesions （5.0%） in the first diagonal branch, 3 lesions （2.1%） in intermediate branch, 2 lesions （1.5%） in posterior descending branch of right coronary artery. In LAD, the MB length ranged from 8 mm to 46 mm and depth ranged from 0.7 mm to 4.4 mm, with the average length of （21.80＋5.98） mm and the average depth of （2.15＋_0.74） mm. The average compression degree was （38.5＋19.6）%. MB was not different in length among different groups（P〉0.05）, but was different in depth（P〈O.05）. MCA systolic compression was positively correlated with MB depth （r=0.408, P〈0.05）, but not with the length of MB （r=0.076, P〉0.05）. Conclusion： 128-slice SCTCA can accurately display the anatomical relationship between the MCA and myocardial tissue and is a preferred method to diagnose MB-MCA. To evaluate the correlation of the degree of MCA systolic compression and MB length and depth can provide the basis for the clinic.