炫速双源CT在心肌桥-壁冠状动脉诊断中的应用

Application of Definition Flash Dual-Source CT in the Diagnosis of Myocardial Bridges-Mural Coronary Artery

目的研究炫速双源CT在心肌桥-壁冠状动脉(MB-MCA)诊断中的应用。方法选择我院2016年4月至2017年4月期间收治的行冠状动脉CTA检查的患者300例,均接受炫速双源CT检查。诊断MB-MCA 198例,根据MB-MCA类型分为两组,观察组为纵深型,对照组为浅表型,回顾性分析两组的临床资料。结果 198例MB-MCA患者中,观察组81例(40.91%),对照组117例(59.09%)。分布部位:130例(65.66%)处于LAD,其中84例位于LAD中段,46例位于LAD远端位置;7例(3.54%)处于RCA中段;53例(26.77%)处于LCX。MB-MCA长度为0.5~3 cm。观察组患者的高血压、糖尿病、高脂血症、典型胸痛、心电图异常比例显著高于对照组,组间差异有统计学意义(P<0.05)。结论冠状动脉MB-MCA多出现在LAD及LCX,炫速双源CT可用于诊断MB-MCA,纵深型MB-MCA较浅表型MB-MCA更易发生心肌缺血。

Objective To study the application of definition flash dual-source CT in the diagnosis of myocardial bridges-mural coronary artery （MB-MCA）. Methods 300 cases of patients who received definition flash dual-source CT inspection in our hospital from April 2016 to April 2017 were selected. 198 cases of patients were diagnosed as MB-MCA, and divided into the observation group （vertical- deep type） and the control group （superficial type） according to the types of MB-MCA. The clinical data of two groups were retrospectively analyzed. Results Among 198 cases of MB-MCA patients, 81 cases （40.91%） were enrolled in observation group and 117 cases （59.09%） were enrolled in control group. 130 cases （65.66%） located in LAD, including 84 cases in middle LAD and 46 cases in distal LAD; 7 cases （3.54%） located in middle RCA; 53 cases （26.77%） located in LCX. The length of MB-MCA was 0.5 - 3 cm. The proportions of patients with hypertension, diabetes, hyperlipidemia, typical chest pain and abnormal ECG in observation group were significantly higher than those in control group （P〈0.05）. Conclusions MB-MCA of coronary artery mostly appears in LAD and LCX. Definition flash dual-source CT can be used to diagnose MB-MCA. Myocardial ischemia is more likely to occur in patient with vertical-deep type MB-MCA than patient with superficial type MB-MCA.