640层CT定量评估桥前冠状动脉粥样硬化患者心肌桥

Quantitative evaluation on patients with atherosclerosis in proximal vessels of myocardial bridge with 640-slice CT

目的观察伴发桥前冠状动脉粥样硬化的心肌桥(MB)及壁冠状动脉(MCA)形态学特征。方法回顾性分析1200例接受640层冠状动脉CT扫描患者资料,其中251例检出MB;根据MB桥前冠状动脉是否伴有粥样硬化,将其分为无粥样硬化组和粥样硬化组,比较两组MB位置、厚度以及MCA长度、走行及压缩程度的差异。结果 251例中共检出262处MB,其中粥样硬化组123例(133处),无粥样硬化组128例(129处)。粥样硬化组与无粥样硬化组中MB厚度分别为(1.61±0.99)mm、(1.35±0.67)mm(P<0.05),MCA长度分别为(18.87±12.28)mm、(18.09±7.73)mm(P>0.05)。粥样硬化组与无粥样硬化组MB位置差异无统计学意义(χ2=0.392,P=0.822)。粥样硬化组中,共93处MB近端或远端存在血管纡曲成角;无粥样硬化组中为66处,二者差异有统计学意义(χ2=9.662,P=0.002);两组MCA压缩程度差异有统计学意义(t=-2.667,P=0.011)。结论与未合并桥前冠状动脉粥样硬化的MB相比,并发粥样硬化者MB较厚,MCA压缩程度大,近、远端血管走行相对纡曲。

Objective To observe the morphology of myocardial bridge （MB） and mural coronary artery （MCA） in patients with atherosclerosis in proximal vessels of MS. Methods Data of 1200 patients underwent CT coronary angiography （CTCA） using 640-slice CT were retrospectively analyzed. MS was detected in 251 patients. Based on the findings of atherosclerosis in proximal vessels of MB, these patients were divided into atherosclerosis group and non-atherosclerosis group. The location and thickness of MS, the tortuosity, length and compression extent of MCA were compared between two groups. Results Totally 262 MS were detected in 251 patients, including 123 patients （133 MB） in atherosclerosis group and 128 patients （129 MB） in non-atherosclerosis group. The thickness of MS was （1.61±0.99）mm and （1.35±0.67）mm, the length of MCA was （18.87±12.28）ram and （18.09±7.73）mm in atherosclerosis group and non-atherosclerosis group, respectively. No statistical difference of location of MB was found between the two groups （X^2 = 0. 392, P=0. 822）. In atherosclerosis group and non-atberosclerosis group, 93 MS and 66 MB with tortuosity of proximal or distal vessels were detected, respectively （X^2 = 9. 662, P= 0. 002）, and statistical difference of compression extent of MCA was found between the two groups （t=-2. 667, P =0. 011）. Conclusion Compared with isolated MB, MB with atherosclerosis are thicker, while MCA are compressed more heavily and more tortuose.