256排螺旋CT血管造影检查与经导管行冠状动脉造影对心肌桥-壁冠状动脉诊断价值的对比研究

摘要

Objective To compare the diagnostic value of 256 - slice spiral CT with that of transcatheter coronary angiography ( CAG ) in diagnosing myocardial bridge and mural coronary artery ( MB - MCA ).Methods Imaging data of 267 patients receiving 256 - slice spiral CTA or CAG were analyzed regressively.The presence of MB - MCA was judged, and its lengths and degrees of stenosis evaluated.Results CTA found 124 MB - MCA segments in 120 patients, including 56 segments of deep - in MB - MCA, 68 segments of superficial MB - MCA.CAG found 117 MB - MCA segments in 108 patients, including 56 segments of deep - in MB - MCA, 61 segments of superficial MB - MCA.Their kappa consistency was good.The lengths of deep - in MB - MCA detected by CTA or CAG were ( 10.83 ± 5.30 ) mm, ( 9.03 ± 4.21 ) mm, respectively, the difference was significant ( P < 0.05 ); The coronary stenosis degrees by CTA or CAG were (51 ±11 )% , ( 52 ± 10 )% , respectively, the difference was not significant ( P > 0.05 ).The lengths of superficial MB - MCA detected by CTA or CAG were ( 7.58 ± 2.12 ) mm, ( 4.54 ± 2.08 ) mm, respectively, the difference was significant ( P < 0.01 ); The coronary stenosis degrees by CTA or CAG were ( 28 ± 10 )% , ( 32.3 ± 11)% , respectively, the difference was not significant ( P > 0.05 ).Conclusion 256 - slice spiral CTA, one of the preferred methods for MB - MCA diagnosis, has good consistency with transcatheter CAG in diagnosis of MB - MCA.%目的 对比分析256排螺旋CT血管造影技术(CTA)与经导管行冠状动脉造影(CAG)对心肌桥-壁冠状动脉(MB-MCA)的诊断价值.方法 回顾性分析2010年7月-2012年6月267例在我院同时接受256排螺旋CTA和CAG检查患者的影像资料,分析冠状动脉的影像表现,判断有无MB-MCA存在,并评估MB-MCA的长度和狭窄程度.结果 CTA共发现120例患者中存在124段MB-MCA,包括深在型MB-MCA 56段,浅表型MB-MCA 68段.CAG发现108例患者存在117段MB-MCA,包括深在型MB-MCA 56段,浅表型MB-MCA 61段.两种检查方法对深在型MB-MCA和浅在型MB-MCA的诊断一致性好(Kappa=0.877、1.000).CTA和CAG测量深在型MB-MCA的长度分别为(10.83±5.30)mm 和 (9.03±4.21)mm,差异有统计学意义(P＜0.01);CTA和CAG测量深在型MB-MCA的狭窄程度分别为(51±11)% 和(52±10)%,差异无统计学意义(P＞0.05).CTA和CAG测量浅在型MB-MCA的长度分别为(7.58±2.12)mm 和(4.54±2.08)mm,差异有统计学意义(P＜0.05);CTA和CAG测量浅表型MB-MCA的狭窄程度分别为(28±10)%和(32.3±11)%,差异无统计学意义(P＞0.05).结论 256排螺旋CTA在诊断MB-MCA方面与经导管CAG有良好的一致性,推荐用于MB-MCA的诊断.