CTA技术在心肌桥-壁冠脉血管形态学诊断中的应用价值

Diagnostic value of CTA regarding myocardial bridge and mural coronary angiomorphology

目的探讨螺旋CT血管造影检查(CTA)技术在心肌桥-壁冠脉血管形态学诊断中的应用价值。方法前瞻性选取2015年1月至2017年1月张家口市第一医院收治的经冠脉造影(CAG)检查确诊的心肌桥-壁冠脉(MBMCA)患者97例作为研究对象。所有患者入院后均接受CTA,根据CTA影像资料进行诊断与评估MB-MCA类型及MB长度、MCA狭窄程度,并与CAG诊断结果进行对比,探讨CTA在MB-MCA血管形态诊断中的应用价值。结果 97例患者均经CAG确诊为MB-MCA,以CAG诊断结果作为金标准与比较对象,CTA在诊断MB-MCA发生类型中CAG诊断结果具有良好的一致性,Kappa=0. 802、1. 000; CTA评估的浅在型MB-MCA与深在型MB-MCA患者MB长度均高于CAG检查,差异具有统计学意义(P <0. 05);但对MCA狭窄程度的评估结果与CAG比较无显著差异(P> 0. 05)。结论 CTA在心肌桥-壁冠脉血管形态评估与诊断中具有较高的准确性,与金标准CAG诊断结果具有良好的一致性,能够有效、准确评估MCA狭窄程度,具有临床应用及推广价值。

Objective To discuss the diagnostic value of CTA regarding myocardial bridge and mural coronary angiomorphology.Methods 97 patients who were confirmed by coronary angiography(CAG)as myocardial bridge and mural coronary artery(MB-MCA)were selected in our hospital from January 2015 to January 2017.All patients received spiral CT angiography(CTA)on admission and evaluate MB-MCA type,MB length and MCA stenosis.CTA results were compared with CAG which was deemed as the gold standard.Results CTA had good diagnostic consistency regarding MB-MCA type compared with CAG(kappa=0.802,1.000).CTA performed better in assessing MB length of MB-MCA(P<0.05).However,there was no significant difference in evaluation of MCA stenosis compared with CAG(P >0.05).Conclusion CTA has high accuracy in assessment and diagnosis regarding myocardial bridge and mural coronary angiomorphology.