摘要
目的:探讨64排螺旋CT冠脉血管造影中心肌桥-壁冠状动脉(MB-MCA)的成像特点及临床特征。材料与方法:对60例经64排螺旋CT血管造影诊断为单纯性心肌桥的患者进行数据重建并进行后处理,对后处理的CTA图像结果与临床症状及心电图进行对比分析。结果:60例均为左冠状动脉前降支(LAD)心肌桥,位于LAD远段8例,中断50例,近段2例。其中25例有胸痛症状,18例心电图提示有ST-T改变并运动负荷试验阳性。收缩期重建发现60段管腔狭窄,13例狭窄程度等于或大于70%,22例处于50%-70%,25例小于50%。舒张期重建发现29段管腔狭窄。发现此改变与心肌缺血症状、心电图ST-T段改变有一定关联。结论:心肌桥引起冠状动脉收缩期的高度狭窄可导致心肌缺血症状、心电图ST-T变化、运动负荷试验阳性。狭窄程度越重,上述表现越显著。64排螺旋CT冠脉血管造影是心肌桥的可靠检出方法并能够对心肌桥的临床意义进行初步判断。
Purpose： To discuss the 64-slice spiral CT imaging character in isolate myocardial bridge patients and the clinical significance of phrase reconstruct. Materials and Methods： 60 patients with isolate myocardial bridge were underg- one coronary angiography with 64 slice spiral CT. All the raw data were rebuilded in two phrases. All the CTA were compared with ECG and clinical manifestations. Results： 60 patients had myocardial bridge over the left anterior descending arteries. 25 patients had chest pain and 18 patients had ST-T abnormality in electrocardiogram. Among the patients with isolated myo- cardial bridge, 13 patients had I〉70% systolic narrowing of coronary 22 patients had 50% -70% , 25 patients had ~〈50% . By comparing the result with ECG and clinlcal symptom, vascular were stenosis is relevant to myocardial ischemia snd ECG ST-segment elevation. Conclusion： Myocardial bridge could be responsible for symptoms of myocardial ischemia, ST-Tabnor- mality in electrocardiogram and positive result in exercise testing. The symptoms were associated with the degree of narrowing of the left anterior descending artery during systole. Myocardial bridge could be found by 64-slice CT and that phrase recon- structing coronary angiography can make a prejudgement to the slinieal significance of isolate myocardial bridge.
出处
《现代医用影像学》
2014年第1期26-29,共4页
Modern Medical Imageology
