256排螺旋CT血管造影检查与经导管行冠状动脉造影对心肌桥-壁冠状动脉诊断价值的对比研究

Comparison between 256-slice Spiral CTA and Coronary Artery Angiography in Diagnosis of Myocardial Bridge and Mural Coronary Artery

目的对比分析256排螺旋CT血管造影技术(CTA)与经导管行冠状动脉造影(CAG)对心肌桥-壁冠状动脉(MB-MCA)的诊断价值。方法回顾性分析2010年7月—2012年6月267例在我院同时接受256排螺旋CTA和CAG检查患者的影像资料,分析冠状动脉的影像表现,判断有无MB-MCA存在,并评估MB-MCA的长度和狭窄程度。结果 CTA共发现120例患者中存在124段MB-MCA,包括深在型MB-MCA 56段,浅表型MB-MCA68段。CAG发现108例患者存在117段MB-MCA,包括深在型MB-MCA 56段,浅表型MB-MCA 61段。两种检查方法对深在型MB-MCA和浅在型MB-MCA的诊断一致性好(Kappa=0.877、1.000)。CTA和CAG测量深在型MB-MCA的长度分别为(10.83±5.30)mm和(9.03±4.21)mm,差异有统计学意义(P<0.01);CTA和CAG测量深在型MB-MCA的狭窄程度分别为(51±11)%和(52±10)%,差异无统计学意义(P>0.05)。CTA和CAG测量浅在型MB-MCA的长度分别为(7.58±2.12)mm和(4.54±2.08)mm,差异有统计学意义(P<0.05);CTA和CAG测量浅表型MB-MCA的狭窄程度分别为(28±10)%和(32.3±11)%,差异无统计学意义(P>0.05)。结论 256排螺旋CTA在诊断MB-MCA方面与经导管CAG有良好的一致性,推荐用于MB-MCA的诊断。

Objective To compare the diagnostic value of 256 - slice spiral CT with that of transcatheter coronary an- giography （CAG） in diagnosing myocardial bridge and mural coronary artery （MB -MCA）. Methods Imaging data of 267 pa- tients receiving 256 - slice spiral CTA or CAG were analyzed regressively. The presence of MB - MCA was judged, and its lengths and degrees of stenosis evaluated. Results CTA found 124 MB - MCA segments in 120 patients, including 56 segments of deep - in MB - MCA, 68 segments of superficial MB - MCA. CAG found 117 MB - MCA segments in 108 patients, including 56 segments of deep - in MB - MCA, 61 segments of superficial MB - MCA. Their kappa consistency was good. The lengths of deep -in MB -MCA detected by CTA or CAG were （10.83 ±5.30） mm, （9.03 ±4.21） ram, respectively, the difference was significant （ P 〈 0.05 ） ; The coronary stenosis degrees by CTA or CAG were （51 ± 11 ） %, （ 52 ±10） %, respectively, the difference was not significant （ P 〉 0. 05 ）. The lengths of superficial MB - MCA detected by CTA or CAG were （ 7.58 ± 2. 12） mm, （4. 54 ± 2.08 ） mm, respectively, the difference was significant （P 〈 0.01 ） ; The coronary stenosis degrees by CTA or CAG were （28 ± 10） %, （32. 3 ±11 ） %, respectively, the difference was not significant （ P 〉 0. 05 ）. Conclusion 256 - slice spiral CTA, one of the preferred methods for MB - MCA diagnosis, has good consistency with transeatheter CAG in diagnosis of MB - MCA.