目的：研究冠状动脉先天性变异与畸形的CT表现。方法：以本院1 402例行冠脉CTA的患者为研究对象，采用前置性门控成像序列扫描，利用各种后重建技术对原始资料分析，总结冠脉先天性变异与畸形的CT表现。结果：本研究共发现冠脉先天性变异与畸形364例，左主干缺如1例，左主干短小3例（其中1例合并副冠状动脉），副冠状动脉或第三冠状动脉2例，右冠起源于左冠状窦7例，单一冠状动脉1例，冠脉异常吻合1例，右后降支冠状动脉瘤并左心房憩室1例，冠状动脉瘤样扩张3例，冠脉动脉迂曲20例，心肌桥-壁冠状动脉325例。结论：宝石CT前置性门控技术扫描既可以大幅降低冠脉CTA的辐射剂量又可以准确清晰显示冠状动脉先天性变异与畸形。
Abstract
Objective: To research the CT findings of congenital variation and malformation of coronary artery. Methods: There were 1 402 patients who had underwent prospective ECG-triggering coronary CTA in our hospital were enrolled this study. We reconstructed the raw data by several post-processing techniques and summarized the CT findings of congenital variation and malformation of coronary artery. Results: We found 364 cases of variation and malformation of coronary artery in this study, including one case of absence of left main coronary artery, 3 cases of short left main coronary artery and one of them has accessary coronary artery, 3 cases of accessary coronary artery or third coronary artery, 7 cases of right coronary originated from the left coronary sinus, one case of single coronary artery, one case of abnormal coronary artery anastomosis, one case of the right posterior descending coronary artery aneurysm with left atrial diverticulum, three cases of coronary artery aneurysm, 20 cases of coronary artery tortuosity, 325 cases of myocardial bridge-mural coronary artery. Conclusion: Prospective ECG-triggering coronary CTA can significantly reduce the radiation dose of coronary CTA and can accurately and clearly show the variation and malformation of coronary artery.
关键词
冠状动脉疾病；体层摄影术 /
螺旋计算机；血管造影术
Key words
Coronary disease /
Tomography, spiral computed /
Angiography
中图分类号：
Ｒ543.3
R814.42
Ｒ814.43
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参考文献
[1]Tariq R, Kureshi SB, Siddiqui UT, et al. Congenital anomalies of coronary arteries: diagnosis with 64 slice multidetector CT[J]. Eur J Radiol, 2012, 81(8): 1790-1797.
[2]Lee HJ, Hong YJ, Kim HY, et al. Anomalous origin of the right coronary artery from the left coronary sinus with an interar-terial course: subtypes and clinical importance[J]. Radiology, 2012, 262(1): 101-108.
[3]Millerj A, Anavekar NS, Yaman EL, et al. Computed tomographic angiography identification of intramural segments in anomalous coronary arteries with interarterial course[J]. Int J Cardiovasc Imaging, 2012, 28(6): 1525-1532.
[4]王芳，吴恩福，姜亿一，等. 238例16排SCT对心脏冠状动脉解剖形态的显示结果分析[J]. 温州医学院学报， 2010，40（6）：596-598.
[5]柏树令，应大君. 系统解剖学[M]. 7版. 北京：人民卫生出版社，2008：207-209.
[6]谢丽响，李绍东，徐凯，等. 双源CT诊断冠状动脉起源异常的价值[J]. 检验医学与临床，2011，8（12）：1414-1415.
[7]姚金龙，龚艳艳. 64层螺旋CT诊断先天性右冠状动脉缺如一例[J]. 放射学实践，2013，28（4）：419.
[8]王士军，苏海，陈菊华. 单支冠状动脉畸形一例[J]. 临床放射学杂志，2007，26（2）：157.
[9]霍勇，洪涛，陈明. 支架治疗儿童左冠状动脉起源异常并主干狭窄[J]. 中国介入心脏病学杂志，2004，12（5）：319.
[10]戴沁怡，吕飙，张兆琪. 64层螺旋CT诊断成人冠状动脉起源异常[J]. 中华放射学杂志，2006，40（8）：804-807.
[11]Athanasias DA, van Ommen V, Bar F. Cononary artery-pulmonary artery fistula originating from the left anterior descend-ing artery: a case report and literature review[J]. Hellenic J Cardiol, 2002, 43(2): 78-81.
[12]Werner B, Wroblewska KM, Pleskot M, et al. Anomalies of the coronary arteries in children[J]. Med Sci Monit, 2001, 7(6): 1285-1291.
[13]杨立，赵林芬，李颖，等. 心肌桥和壁冠状动脉的多层螺旋CT诊断及其临床意义[J]. 中华医学杂志，2006，86（40）：2858-2862.
[14]刘世合，柳澄，王锡明，等. 双源CT对壁冠状动脉狭窄程度与心肌桥长度和厚度相关性的研究[J]. 中华放射学杂志，2009，43（2）：173-177.
[15]赵林芬，许绍奇，周雪芳，等. CTA判断壁冠状动脉管腔狭窄程度最佳重建时相及管腔狭窄与MB-MCA特征相关性研究[J]. 放射学实践，2013，28（3）：333-336.
[16]吕滨，蒋世良. 心血管病CT诊断[M]. 北京：人民军医出版社，2012：55-56.
[17]顾玲玲，刘士远，于红，等. 先天性冠状动脉变异的256层螺旋CT诊断[J]. 实用放射学杂志，2013，29（8）：1234-1237.
