256层CT冠脉成像对壁冠状动脉管腔变化的观察与分析

Analysis of lumen changes of mural coronary artery with brilliance CT 256 coronary angiography

目的探讨256层CT冠脉成像评价心肌桥血管管腔变化的临床应用价值。方法随机抽取我院2010年12月～2012年1月进行冠状动脉CTA检查患者200例作为研究对象,对比剂使用碘海醇65～80ml,流速5.0～5.5ml/s,采用Surestar技术跟踪扫描,阈值150HU;采用多种图像后处理技术:容积重组(VR)、多平面重组(MPR)、曲面重组(CPR)及最大密度投影(MIP),对壁冠状动脉采用45%时相(收缩期)、75%时相(舒张期)进行观察。结果 200例受检者中,心肌桥78例(39%),其中左前降支62例(79.5%),浅表型52例(66.7%),深在型26例(33.3%),浅表型收缩期管腔狭窄15%～20%,平均16.5%,深在型收缩期管腔狭窄40%～70%,平均52%。结论 256层CT冠脉成像能够清晰显示心肌桥形态,通过收缩期和舒张期成像可对壁冠状动脉管腔压缩程度进行评价,为临床提供有价值的血液动力学方面的信息。

Objective To investigate the diagnostic value of Brilliance CT 256 coronary angiography in lumen changes of mural coronary artery. Methods 200 patients were randomly selected with MSCTA from 2010. 12 to 2012.1, the contrast medium （Iohexol 350 mg/100ml） was 60~80 ml, the rate was 5.0~5.5 ml/s with bolus tracking techniques, the thresh- old was 150 HU, and excretory-phase images were transferred to the workstation and performed volume rendering （VR）, multilanar reeonstr- uction （MPR）, curved planar reconstruction （CPR） and maximun intensity projection （MIP）. Mural coronary artery was objected in 45% phase （systole phase） and 75% phase （diastole phase）. Results In 200 cases, the patients of myocardial bridge were 78 cases （39%）, in which 62 cases were in the left anterior descending artery （79.5%）, the superficial mural coronary artery was 52 cases （66. 7%）, the deep mural coronary artery was 26 cases （33.3%）. The diameter stenosis of the superficial mural coronary artery in systole phase was 15~/00 ~20~ （mean, 16.5~） ; the diameter stenosis of the deep mural coronary artery in systole phase was 40%~70% （mean, 520/oo）. Conclu- sion 256 CTCA can clearly show myocardial bridge, assess lumen changes of mural coronary artery with images of systole phase and diastole phase, and provide hemodynamic information for clinical treatment and surgery.