冠状动脉CTA与DSA诊断心肌桥的临床价值探讨

Clinical value of coronary CTA and DSA in diagnosis of myocardial bridge

目的探讨心肌桥患者采用冠状动脉CT血管造影(CTA)、数字减影血管造影术(DSA)诊断的临床价值。方法96例心肌桥患者,分别行冠状动脉CTA、DSA检查。以病理学检查结果作为金标准,比较两种方法的诊断准确率及对不同位置(左冠前降支、左冠回旋支、对角支、右冠)心肌桥的检出准确率。结果冠状动脉CTA的诊断准确率为97.92%,显著高于DSA的68.75%,差异具有统计学意义(P<0.05)。病理学检查结果显示,心肌桥在左冠前降支35例,左冠回旋支30例,对角支17例,右冠14例。冠状动脉CTA对左冠前降支、左冠回旋支、对角支、右冠心肌桥的检出准确率分别为100.00%、100.00%、94.12%、92.86%,均高于DSA的71.43%、73.33%、64.71%、57.14%,差异具有统计学意义(P<0.05)。结论在心肌桥的临床诊断中,冠状动脉CTA的诊断准确率更高,能够清晰呈现壁血管的形态特点与心肌桥的分布特点,值得推广。

Objective To discuss the clinical value of coronary CT angiography(CTA)and digital subtraction angiography(DSA)in diagnosis of patients with myocardial bridge.Methods 96 patients with myocardial bridges were examined by coronary CTA and DSA.The pathological findings were used as the gold standard to compare the diagnostic accuracy of the two methods and the diagnostic accuracy of myocardial bridges in different locations(left anterior descending coronary artery,left circumflex coronary artery,diagonal branch,right coronary artery).Results The diagnostic accuracy of coronary CTA was 97.92%,which was significantly higher than 68.75%of DSA,and the difference was statistically significant(P<0.05).Pathological examination showed that myocardial bridges were located in the left anterior descending coronary artery in 35 cases,the left circumflex coronary artery in 30 cases,the diagonal branch in 17 cases,and the right coronary artery in 14 cases.The diagnostic accuracy of myocardial bridge at left anterior descending coronary artery,left circumflex coronary artery,diagonal branch,right coronary artery were 100.00%,100.00%,94.12%,and 92.86%,which were higher than 71.43%,73.33%,64.71%,and 57.14%of DSA,and the differences were statistically significant(P<0.05).Conclusion In the clinical diagnosis of myocardial bridge,the diagnostic accuracy of coronary CTA is high,which can clearly show the morphological characteristics of mural vessels and the distribution characteristics of myocardial bridge,which is worth promoting.