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目的探讨多层螺旋CT冠状动脉成像(MSCTA)对心肌桥-壁冠状动脉(MB-MCA)的诊断价值。方法收集2013年3月至2014年3月临床拟诊冠心病患者385例的MSCTA资料,及其冠状动脉造影(CAG)资料,统计MSCTA发现MB-MCA的例数、段数,然后与CAG结果对照。结果 385例受检者中,CAG检出MB-MCA 61例,检出率为15.8%。MSCTA发现MB-MCA 103例/121段,其中左前降支(LAD)90例/108段(中段72例,近段12例,远段6例),对角支2例,左钝缘支2例,左回旋支(LCX)远段2例,右冠脉(RCA)7例(近段1例,中段5例,远段1例);且部分病例为单支多发:LAD两段10例,LAD合并对角支1例,LAD合并LCX 1例,LAD多段3例。MSCTA对MB-MCA检出率为26.8%,其中发生于LAD占MB-MCA的87.4%(90/103)。结论 MSCT具有安全、方便、准确、无创等优点,是心肌桥及MCA检出的理想方法。
Objective To investigate the diagnostic value of multislice CT coronary angiography (MSCTA) in the diagnosis of myocardial bridge-wall coronary artery (MB-MCA). Methods The data of 385 patients with suspected coronary heart disease in our hospital from March 2013 to March 2014 were collected and their data of coronary artery angiography (CAG) were collected. The number of MB-MCA found in MSCTA and the number of segments were collected, and then compared with CAG results . Results Of the 385 subjects, 61 were detected by CAG and the detection rate was 15.8%. There were 103 cases / 121 segments of MB-MCA in MSCTA group, of which 90 cases / 108 segments (72 in middle segment, 12 in proximal segment, 6 in distal segment), 2 diagonal branches, 2 left oblique margin Cases, left circumflex artery (LCX) distal segment in 2 cases, right coronary artery (RCA) in 7 cases (proximal 1, middle 5, distal 1); and some cases of single multiple: LAD 10 , LAD combined diagonal branch in 1 case, LAD combined with LCX in 1 case, LAD multi-segment in 3 cases. The detection rate of MB-MCA by MSCTA was 26.8%, which occurred in 87.4% (90/103) of L-MB-MCA. Conclusion MSCT is safe, convenient, accurate and noninvasive. It is an ideal method to detect myocardial bridge and MCA.