双源CT冠状动脉造影在成人冠状动脉起源异常中的应用

Application of dual source CT in diagnosis of anomalous origin of coronary artery in adult patients

目的 探讨双源CT（dual source CT,DSCT）在诊断成人冠状动脉起源异常（anomalous origin of coronary artery,AOCA）的价值.方法 收集接受DSCT冠状动脉造影检查的11 102例患者的资料,对患者图像行最大密度投影（MIP）、容积再现（VR）、多平面重建（MPR）和曲面重建（CPR）后处理,观察冠状动脉起源及走行.结果 11 102例患者中,共检出AOCA 116例,检出率为1.04%,其中右冠状动脉起源异常62例（53.45%,62/116）,左冠状动脉起源异常45例（38.79%,45/116）,右冠状动脉和左冠状动脉均高位开口4例（3.45%,4/116）,单支冠状动脉5例（4.31%,5/116）.结论 DSCT冠状动脉CT血管造影检查能准确直观地显示冠状动脉的起源及走行,可作为无创性检出冠状动脉变异的首选方法.

Objective To investigate the value of dual source CT （DSCT） in diagnosis of congenital anomalous ori- gin of coronary artery （AOCA） in adult patients. Methods DSCT coronary angiography data in 11 102 patients were an- alyzed. Maximum intensity projection （MIP） , volume rendering （ VR ） , multiplanar reformation （ MPR ） , and curved planar reconstruction（CPR） were used to demonstrate the origin and course of the coronary arteries. Results In 11 102 patients, 116 patients with AOCA were found, there were 62 cases of anomalous origin of right coronary artery （53.45% , 62/116） , 45 cases of anomalous origin of left coronary artery （38.79%, 45/116）. 4 patients had high ori- fice of both coronary arteries （3.45%, 4/116） and single coronary artery in 5 cases （4.31% , 5/116）. Conclusion DSCT coronary angiography can clearly visulize anomalous origin and course of coronary arteries, and it should be consid- ered a prime non -invasive imaging tool for suspected AOCA.