作者：王思云， 杨有优 ， 周旭辉， 罗初凡， 彭谦， 孟悛非
【摘要】 【目的】 评价64层螺旋CT在诊断冠状动脉畸形方面的临床应用价值。【方法】 对38例冠状动脉畸形的64层螺旋CT资料进行回顾性分析，将原始数据传至工作站，行多平面重建（MPR）、容积再现（VR）、最大密度投影（MIP）和血管探针等后处理。10例同时行传统冠脉造影（CAG），3例行手术。【结果】 38例患者畸形血管在CT图像上得以清晰显示。冠状动脉开口起源异常6例，单支冠状动脉畸形2例，冠状动脉瘘2例，冠状动脉肌桥20例，副冠状动脉8例，10例CAG结果9例与CT一致，1例右侧冠状动脉高位开口CAG误诊为缺如，3例手术结果与CT一致。【结论】 64层螺旋CT冠状动脉造影清晰显示了畸形血管的起源、行程、终止及腔内情况，可作为冠状动脉畸形首选的检查方法。
【关键词】 体层摄影术，X线计算机； 血管造影术； 冠状动脉； 血管畸形
Abstract: 【Objective】 To evaluate the clinical application of 64-slice spiral computed tomography in the diagnosis of coronary artery anomalies (CAAs). 【Methods】 The 64-slice spiral computed tomography images of 38 patients with CAAs were retrospectively analyzed. The raw data were transferred to the work station（vitrea@2 version 3.7.0）, and then multi-planar reconstruction (MPR), volume render (VR), maximum intensity projection (MIP)，curved-planar reconstruction (CPR) and blood vessel probe were performed. Ten patients were performed conventional coronary artery angiography (CAG) and 3 patients were performed surgery. 【Results】 The origin and course of anomalous CA in 38 patients were displayed clearly by 64-slice spiral computed tomography. Six patients were anomalous origin of CA trunk; 2 were single CA anomaly; 2 were the branch of RCA fistula (1 to the pulmonary artery, 1 to the right atrium); 20 were mural coronary artery; 8 were para coronary artery, which is the branch of arterial conus origins directly from the right coronary sinus. Nine results of the 10 CAG were accordant with CT, 1 high origin of RCA was mistaken for congenital absence in CAG. Three operation results were accordant with CT. 【Conclusion】 The 64-slice spiral computed tomography displayed the origins, course and the condition of intralumens of CA clearly. It’s better than CAG on some degree. 64-slice spiral computed tomography could be used as the first choose of imaging tools for suspected CAAs.
Key words：tomography, X-ray