64排螺旋 CT对心肌桥显示及其临床价值

摘要

Abstracts:Objective To observe the 64 slice spiral CT display of characteristics of myocardial bridge ,and investi-gate its clinical value .Methods A total of 199 patients with myocardial bridge were examined by CT angiography in Shaanxi Yulin Xingyuan Hospital from Jan .2014 to Oct.2015 were included in the study ,which all received 64 slice spiral CT coronary artery imaging examination .The 64 row spiral CT characteristics of myocardial bridge were observed .The coro-nary artery atherosclerosis in the myocardial bridge was observed , and the characteristics of the coronary artery were observed.Results A total of 218 myocardial bridge were found in 199 cases,the occurrence rate of the middle left anterior descending branch(LAD) was the highest,the incidence was 63.3%(138/218).The length and thickness of the myocardi-al bridge were the largest in the middle LAD,which were (18.4 ±3.9) mm and (2.9 ±0.8) mm respectively.There were 124 coronary artery atherosclerosis in the 218 patients with myocardial bridge ,the occurrence rate was 56.9%(124/218). The percentage of total coronary artery atherosclerosis was significantly higher than that of incomplete type [ 64.4% ( 85/132 ) vs 45.3%( 39/86 ) ] ( P<0.05 ) .There were 124 cases of atherosclerosis in the anterior section of the myocardial bridge,the occurrence rate was 56.9%(124/218),which was higher than that of the posterior section of myocardial bridge′s 9.2%(20/218)(P<0.05).of the atherosclerosis incidence of myocardial bridge coronary artery with tortuosity angulation was 62.8%(137/218),significantly higher than the normal course 37.2%(81/218),and the stenosis degree of tortuous angulated coronary artery was higher than the coronary artery with normal course [ ( 26.5 ±7.5 )% vs ( 19.5 ± 5.3 )%] ( P<0.05 ) .Conclusion 64 slice spiral CT can clearly show the characteristics of myocardial bridge and wall of coronary artery,and is a good imaging evaluation method .%目的：观察64排螺旋CT对心肌桥形态特征的显示情况，探讨其临床价值。方法选择2014年1月至2015年10月于陕西省榆林市星元医院影像中心接受CT冠状动脉造影检查并确诊为心肌桥的患者199例，均接受64排螺旋CT冠状动脉成像检查。观察心肌桥的64排螺旋CT特征，载心肌桥冠状动脉发生动脉硬化的情况。结果199例患者共显示218处心肌桥，其中左前降支（LAD）中段发生率最高，为63．3％（138／218）。心肌桥长度及厚度均以LAD中段最大，分别为（18．4±3．9） mm和（2．9±0．8） mm。218处载心肌桥冠状动脉中124处冠状动脉发生动脉硬化，发生率为56．9％（124／218）。完全型心肌桥发生载心肌桥冠状动脉硬化的比例显著高于不完全型心肌桥[64．4％（85／132）比45．3％（39／86）]（P＜0．05）。心肌桥前段冠状动脉发生载心肌桥冠状动脉硬化124处，发生率为56．9％（124／218），高于心肌桥后段的9．2％（20／218）（P＜0．05）。载心肌桥冠状动脉迂曲成角者冠状动脉发生率为62．8％（137／218），显著高于走行正常者的37．2％（81／218），迂曲成角冠状动脉狭窄程度高于正常者[（26．5±7．5）％比（19．5±5．3）％]（ P＜0．05）。结论64排螺旋CT可以清晰显示心肌桥及壁冠状动脉的特征，是良好的影像学评价方法。