冠状动脉旁路移植术前应用多层螺旋CT血管造影术评估胸廓内动脉的临床价值

The evaluation of internal thoracic artery using multi-slice spiral CT angiography before coronary artery bypass grafting:clinical considerations

目的 探讨冠状动脉旁路移植术前应用多层螺旋CT血管造影术(MSCTA)评估胸廓内动脉解剖特性的临床价值.方法 应用MSCTA技术对199例CABG术前患者的胸廓内动脉进行分析,测量左胸廓内动脉长度,观察其起源、走行、分支、变异情况.结果 199例胸廓内动脉主干及其终支均能清晰显现,其中45例发生起源变异,变异率为22.6%,不同性别之间比较无统计学意义(P>0.05).变异类型以甲状颈干共干多见,占42例(21.1%),另有1例(0.5%)起自肩胛上动脉,2例(1.0%)起自腋动脉.左胸廓内动脉平均长度(193.80±28.74)mm,性别差异无统计学意义(P>0.05).结论 MSCTA可以清晰显示胸廓内动脉的起源、主要分支及变异等解剖结构,对冠状动脉旁路移植术前预评估有重要意义.

Objective To explore the anatomical characteristics of intermal thoracic artery using multi:slice spiral CT angiography(MSCTA)before coroary artery bypass gaftin Methods The imges of inteml thoracic arteries in 199 patients before CABG were analyzed.The lengths of left intemal thoracic artery were measured.The origins,main branches,courses and variations of left intermal thoracic artery were observed.Results All the intemal thoracic artery trunks and their final branches were clearly displayed.45 cascs had anatomical variations with the variation rate of 22.6%.There was no statistical significance between different genders(P>0.05).The thyrocervical trunk variation was the most common type,accounting for 42 cases(21.1%).The left internal thoracic artery originated from the suprascapular artery(1 case)and the axillary artery(2 cases)in 0.5%and 1.%,rsecievle.The average length of lef intma toracic ateries was(193.8028.74)1 mm.There was no satistal sgnicnce btweven difirenr genders(P>0.05).Concusion MSCTA cen clearly show the origin,the main branch and the variatin of intermal thoraic artery.There is a certin significance of making the asessment before CABG.