256层螺旋ct血管造影与数字减影血管造影在诊断冠状动脉心肌桥的效果比较

Diagnosis of Coronary Myocardial Bridge by 256-Slice Spiral CT and DSA a Comparative Study

目的:比较256层螺旋ct血管造影(CT angiography,CTA)与数字减影血管造影(Digital Subtraction Angiography,DSA)在诊断冠状动脉心肌桥的效果。方法:选取2017年6月至2020年6月于我院诊断为冠心病的患者120例作为研究对象,所有患者均采取256层CTA和DSA检查诊断,比较两组患者冠状动脉狭窄检查情况以及心肌桥的检出率。结果:256层CTA检查组中,共检出93例冠状动脉狭窄,轻度狭窄56例,中度狭窄28例,重度狭窄9例,而DSA共检出85例冠状动脉狭窄,其轻度、中度和重度狭窄分别为55例、21例和9例,两种方法在诊断冠状动脉病变上一致性较好(kappa=0.741,P<0.001);256层CTA检查组中,冠状动脉心肌桥检出率为80.00%,显著高于DSA检查组中冠状动脉心肌桥检出率68.33%(P<0.05)。结论:256层CTA可直接显示心肌桥以及血管的形态学特征,和DSA相比对解剖结构异常和心肌桥的诊断更具有优势,不过,该方法对患者心率要求较高,且CTA和DSA在检查冠状动脉病变上具有高度一致性,因此临床医师在实际检测过程中,可根据实际情况灵活应用,以发挥各自优势,提高患者心肌桥的检出率。

Objective:To compare the effects of 256-slice spiral CT angiography(CTA)and digital subtraction angiography(DSA)in the diagnosis of coronary myocardial bridge.Methods:A total of 120 patients diagnosed with coronary heart disease in the hospital from June 2017 to June 2020 were selected as the study objects.All patients were diagnosed by 256-slice CTA and DSA.The situation of coronary artery stenosis and detection rate of myocardial bridge were compared between the two groups.Results:Through 256-slice CTA,a total of 93 cases with coronary artery stenosis were verified,including 56 cases with mild stenosis,28 cases with moderate stenosis,and 9 cases with severe stenosis.Through DSA 85 cases of coronary artery stenosis were verified,and the mild,moderate and severe stenosis were 55 cases,21 cases and 9 cases respectively.The two methods had good consistency in the diagnosis of coronary artery disease(kappa=0.741,P<0.001).The detection rate of coronary myocardial bridge by 256-slice CTA was 80.00%,significantly higher than 68.33%by DSA(P<0.05).Conclusion:256-slice CTA can directly display the morphological characteristics of myocardial bridge and blood vessels.Compared with DSA,it has more advantages in the diagnosis of abnormal anatomical structure and myocardial bridge.However,this method requires high for patients’heart rate,and CTA and DSA have high consistency in the detection of coronary artery lesions.Therefore,clinicians can flexibly apply it according to the actual situation in the actual detection process,so as to play their respective advantages and improve the detection rate of myocardial bridge in patients.