心肌桥的双源CT诊断及临床意义.docVIP

心肌桥的双源CT诊断及临床意义 张雪梅 王健 黎川 李丹 （第三军医大学附属西南医院放射科，重庆 400038） 摘 要： 目的 探讨心肌桥（MB）在双源CT冠状动脉血管成像（DSCTCA）中的检出率及形态特征，明确心肌桥与邻近冠状动脉硬化的关系 方法 对835例常规体检或怀疑冠心病者行双源螺旋CT冠状动脉血管成像，观察MB的检出率、位置、长度及深度，并按MB近远端2cm以内有无冠状动脉硬化将所有MB分为2组，比较两组发病年龄以及MB的长度和深度。 结果 835例中发现182例（21.8%）共195段MB，其中183段（93.8%）位于左前降支。MB平均长度19.5 mm±8.2mm，平均深度1.5 mm±0.8mm。所有壁冠状动脉段（MCA）未发现明显粥样硬化癍块，相邻2cm以内冠状动脉段发现动脉硬化癍块75例（38.5%），其中近端66例（33.8％），远端9例（4.6%）。有动脉硬化癍块形成者其发病年龄显著高于无粥样硬化癍块形成者（p0.05），两组壁冠状动脉的深度及长度无显著差异。结论 DSCTCA对MB的检出率较高，且能清楚显示MB的活体形态特征；邻近冠状动脉硬化可能MB长期累积效应所致。 关键词：心肌桥；冠状动脉；CT血管成像 中图法分类号： 文献标识码：A Myocardial bridging: diagnosis with dual-source CT and clinical significance ZHANG Xue-mei, WANG Jian, LI Chuan, LI Dan (Department of Radiology, Southwest Hospital, the third military medical university, Chongqing 400038, China) Abstract： Objective To study the prevalence and morphological features of MB on dual-source computed tomographic coronary angiography (DSCTCA), and to determine the relationship between MB and the neighboring coronary atherosclerosis. Methods Eight hundred and thirty-five consecutive patients with suspected coronary disease or for physical examination were studied with DSCTCA for the presence of myocardial bridging (MB). The number, length, and depth of MB were observed and evaluated. All cases with MB were divided into two groups according the presence or absence of atherosclerosis in the coronary artery 2cm neighboring to the MB. The patient age as well as the length and depth of MB were compared between two groups. Results One hundred and ninety-five MB segments were identified in 182 of 835 (21.8%) patients. Of 195 segments, 182 were located in mid left anterior descending coronary artery (LAD)( 93.8%). The mean length of MB segments was 19.5 mm±8.2mm, and the mean depth 1.5 mm±0.8mm. No evidence of atherosclerosis was detected in the mural coronary artery. In a 2-cm-long segment immediately proximal or distal to the MB, atherosclerotic plaques were found in 75 作者简介：张雪梅（1972－），女，重庆市人，