心肌桥-第三军医大学学报.DOC

心肌桥：冠状动脉CT血管成像与传统冠状动脉造影对比研究 毛芸1 ，阚晓婧1，罗天友1，吕发金1 (重庆医科大学附属第一医院放射科,重庆 400016) 作者简介：毛芸（1979—），女，重庆市人，汉族，硕士学位，初级医师，研究方向：心血管影像和腹部影像，电话（023E-mail： HYPERLINK mailto:maoyun1979@163.com maoyun1979@163.com 目的 与传统冠状动脉造影对比研究64排螺旋冠状动脉CT血管成像在诊断心肌桥方面的临床价值。方法 135例患者纳入本研究并行冠状动脉CTA成像，其中50例CT检查前后两周内行CCA检查。CT图像分析内容包括有无肌桥、肌桥位置、长度、深度分型、收缩期狭窄程度、邻近管壁情况。CCA图像分析内容包括有无肌桥，肌桥位置、长度、收缩期狭窄程度。描述分析两种方法的肌桥检出率，CT中肌桥的位置及邻近管壁情况，评价两种方法收缩期狭窄程度的相关性及差异性，并分析肌桥收缩期狭窄程度与深度及长度之间的相关性。结果 135例患者诊断肌桥91例，共103个，CTA肌桥检出率为67.4%，前降支中段占60.2%，浅表型69个，纵深型34个，50例存在近侧管壁斑块，5例存在远侧管壁斑块。CTA与CCA收缩期狭窄程度间存在相关性，相关系数0.785；CTA中肌桥收缩期狭窄程度与长度间存在正相关性，相关系数0.282；CTA中肌桥收缩期狭窄程度与深度间存在正相关，相关系数0.561。两种方法的收缩期狭窄程度无明显差异性。结论 CTA能直接、清晰显示心肌桥与壁血管的形态学特征；心肌桥深度越深，范围越长，收缩期管腔狭窄越明显；与传统冠状动脉造影相比，冠状动脉CT血管成像能明显提高对心肌桥的检出率，但在对壁血管收缩期狭窄程度测量方面不及传统冠状动脉造影准确。 关键词：冠状动脉CT血管成像，冠状动脉造影，心肌桥，壁血管 The morphology of myocardial bridge at coronary CT angiography in comparision to conventional coronary angiography MAO Yun1, KAN Xiao-jing1, LUO Tian-you1, LV Fa-jin1 (Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing,China,400016) Purpose To evaluate the clinical significance of myocardial bridge at coronary CT angiography(CTA) comparing with conventional coronary angiography(CCA). Methods 135 patients who underwent coronary CT angiography were included in this study,while 50 of these patients underwent conventional coronary angiography within a time interval of two weeks. The depiction rate, precise location,length,depth, systolic stenosis and the situation of the nearby arteries were evaluated in CTA. The depiction rate, precise location, length and the degree of systolic stenosis were evaluated in CCA. Pearson correlation analysis was used to analyze the relation of the degrees of systolic stenosis between two methods and the relation between length ,depth and the degree of systolic stenosis as assessed with CT. The paired t –test was used to compare the degrees of systolic stenosis between two methods. Results