单纯性心肌桥-壁冠状动脉的双源CT表现与心肌缺血的相关性研究

Performance of simple myocardial bridge mural coronary artery in dual source CT and its relation with myocardial ischemia

目的探讨双源CT在检查单纯性心肌桥-壁冠状动脉(MB-MCA)的临床价值,并讨论单纯性MB-MCA与心肌缺血之间的关系。方法回顾双源CT冠脉成像检出的239例单纯性MB-MCA的临床资料。结果双源CT冠脉成像发现239例单纯性MB-MCA患者中90.16%位于左前降支。其中静息心电图提示心肌缺血者的有50例,24 h动态心电图检查有心肌缺血者19例,其余170例无心电图变化。分析两组检测指标发现,MB厚度、MCA横断面面积及狭窄程度比较差异具有统计学意义(P<0.05),而MCA长度比较则差异无统计学意义(P>0.05)。结论双源CT冠脉成像可用于单纯性MB-MCA的诊断,结合心电图及临床相关资料,有助于单纯性心肌桥引起心肌缺血的诊断。

Objective To discuss the clinical significance of dual source CT coronary angiography in simple myocardial bridge-mural coronary artery （MB-MCA）, and to investigate the relationship between simple MB-MCA and myocardial ischemia. Methods The clinical data of 239 cases of simple MB-MCA detected by DSCT were re-viewed. Results In the 239 cases of simple MB-MCA, 90.16%（216/239） were located in the left anterior descend-ing artery. Sixty-nine cases of myocardial ischemia were detected by static ECG （50 cases） and 24 hours Holter （19 cases）, and the remaining 170 cases showed no ECG changes. Analysis showed that there were significant differences between the two groups in MB thickness, MCA systolic cross-sectional area, diastolic cross-sectional area and the de-gree of stenosis （P〈0.05）, but not in MCA length （P〉0.05）. Conclusion Dual source CT coronary angiography can diagnose simple MB-MCA, and its combination with ECG and clinical information can help to diagnose myocardial ischemia caused by simple myocardial bridge.