多层螺旋CT检测冠状动脉起源异常的价值

摘要

目的:探讨多层螺旋CT冠状动脉成像对冠状动脉起源异常(coronary artery origin anomalies,CAOA)的诊断价值.方法:回顾分析9 052例行64层或256层螺旋CT冠状动脉成像患者的资料,对患者图像行容积再现(VR)、多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP),观察冠状动脉起源、走行及管腔情况.结果:9 052例冠状动脉检查者中,检出40例42支CAOA患者,检出率为0.44％,包括右冠状动脉起源于左冠窦26例(1例并发左冠状动脉高位开口),高位开口2例;左冠状动脉起源于主肺动脉2例;左主干起源于右冠窦1例;左回旋支起源于右冠窦6例(1例并发左前降支高位开口),起源于右冠状动脉近段1例;左前降支起源于右冠窦1例;左前降支、左回旋支及中间支单独起源于左冠窦1例.其中异常冠状动脉非斑块性狭窄17例,存在斑块12例(狭窄5例).结论:多层螺旋CT诊断冠状动脉起源异常直观、准确,VR是最佳后处理显示方法,同时有助于成功行导管法冠状动脉造影.%Aim;To explore the value of multi-slice spiral CT Coronary angiography in diagnosis of coronary artery origin anomalies. Methods; Retrospective analysis 64-slice or 256-slice spiral CT coronary angiography data of 9052 patients, All cases were used volume rendering (VR) , multiplanar reformation (MPR) , curved planar reformation (CPR) , Maximum intensity projection (MIP) ,then observed the origin, travel and the lumen of coronary artery. Results; Nine thousands and fifty-two cases of coronary angiography were check 40 cases of CAOA patients(42 supports of coronary artery abnormalities), the detection rate of 0.44% , including the right coronary artery originating from right coronary sinus 26 cases (Concurrent 1 case of high openings of left coronary artery), high level openings in 2 cases; The left coronary artery originated in 2 cases of the main pulmonary artery; left main coronary artery originated from the right coronary sinus 1 cases; LCX originated in the right coronary sinus in 6 cases ( Concurrent 1 case of high openings of left anterior descending artery, LAD) , the origin of the right coronary artery proximal 1 cases; LAD originated from the right coronary sinus in 1 case; LAD, LCX and intermediate branch separate origin of the left coronary sinus 1 cases. Abnormal coronary artery of the non-plaque stenosis 17 cases, there are 12 cases of plaque (stenosis n =5). Conclusion:Multi-slice spiral CT diagnosis of coronary artery origin is extremely intuitive, accurate, and VR is the best post-processing methods, while contributing to the success of the line catheter coronary angiography.