冠状动脉瘤的CT表现探讨

Study on the CT Features of Coronary Artery Aneurysm

目的应用128层CT及双源CT行冠状动脉成像(CTCA)以评价冠状动脉瘤的CT表现。方法前瞻性纳入2011年3月-2014年4月行CTCA检查患者1 108例,通过容积再现、最大密度投影、多平面重建、曲面重建观察冠状动脉血管形态、血管壁光整状态。结果共发现3例冠状动脉瘤。患者1左冠前降支(LAD)近段葡萄状突起;患者2 LAD及左冠回旋支(LCX)、右冠状动脉(RCA)弥漫性扩张伴局部梭行扩张;患者3左主干(LM)起源于肺动脉,LM、LAD及LCX、RCA弥漫性扩张。结论 CTCA是一种无创、简单、有效的诊断冠状动脉瘤的检查方法,可为冠状动脉瘤高危人群筛查首选。

Objective To evaluate the CT features of coronary artery aneurysm by coronary artery imaging on 128 slice CT and dual source CT（CTCA）. Methods A total of 1 108 cases were prospectively examined using CTCA between March 2011 and April 2014. With volume rendering, maximum intensity projection, multiplanar reconstruction and surface reconstruction, we observed the coronary artery morphology and vascular wall condition. Results Three cases of coronary artery aneurysm were found. In case one, the anterior descending branch（LAD） had grape-like prominency segmentally; in case two, LAD and left coronary circumflex branch（LCX） and right coronary artery（RCA） had diffuse dilation with local shuttle expansion; in case three, left main, LAD and LCX and RCA had diffuse expansion. Conclusion CTCA is a noninvasive, simple and effective method for the diagnosis of coronary artery aneurysm, and it can be the first choice for the high risk population with coronary artery aneurysm.