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1、心肌橋的雙源CT診斷及臨床意義張雪梅王健黎川李丹(第三軍醫(yī)大學(xué)附屬西南醫(yī)院放射科,重慶400038)摘要:目的探討心肌橋(MB)在雙源CT冠狀動脈血管成像(DSCTCA)中的檢出率及形態(tài)特征,明確心肌橋與鄰近冠狀動脈硬化的關(guān)系方法對835例常規(guī)體檢或懷疑冠心病者行雙源螺旋CT冠狀動脈血管成像,觀察MB的檢出率、位置、長度及深度,并按MB近遠(yuǎn)端2cm以內(nèi)有無冠狀動脈硬化將所有MB分為2組,比較兩組發(fā)病年齡以及MB的長度和深度。結(jié)果835例中發(fā)現(xiàn)182例(21.8%)共195段MB,其中183段(93.8%)位于左前降支。MB平均長度19.5mm±8.2mm,平均深度1
2、.5mm±0.8mm。所有壁冠狀動脈段(MCA)未發(fā)現(xiàn)明顯粥樣硬化癍塊,相鄰2cm以內(nèi)冠狀動脈段發(fā)現(xiàn)動脈硬化癍塊75例(38.5%),其中近端66例(33.8%),遠(yuǎn)端9例(4.6%)。有動脈硬化癍塊形成者其發(fā)病年齡顯著高于無粥樣硬化癍塊形成者(p<0.05),兩組壁冠狀動脈的深度及長度無顯著差異。結(jié)論DSCTCA對MB的檢出率較高,且能清楚顯示MB的活體形態(tài)特征;鄰近冠狀動脈硬化可能MB長期累積效應(yīng)所致。關(guān)鍵詞:心肌橋;冠狀動脈;CT血管成像中圖法分類號:文獻(xiàn)標(biāo)識碼:AMyocardialbridging:diagnosiswithdual-sourceCTand
3、clinicalsignificanceZHANGXue-mei,WANGJian,LIChuan,LIDan(DepartmentofRadiology,SouthwestHospital,thethirdmilitarymedicaluniversity,Chongqing400038,China)Abstract:ObjectiveTostudytheprevalenceandmorphologicalfeaturesofMBondual-sourcecomputedtomographiccoronaryangiography(DSCTCA),andtodet
4、erminetherelationshipbetweenMBandtheneighboringcoronaryatherosclerosis.MethodsEighthundredandthirty-fiveconsecutivepatientswithsuspectedcoronarydiseaseorforphysicalexaminationwerestudiedwithDSCTCAforthepresenceofmyocardialbridging(MB).Thenumber,length,anddepthofMBwereobservedandevaluat
5、ed.AllcaseswithMBweredividedintotwogroupsaccordingthepresenceorabsenceofatherosclerosisinthecoronaryartery2cmneighboringtotheMB.ThepatientageaswellasthelengthanddepthofMBwerecomparedbetweentwogroups.ResultsOnehundredandninety-fiveMBsegmentswereidentifiedin182of835(21.8%)patients.Of195s
6、egments,182werelocatedinmidleftanteriordescendingcoronaryartery(LAD)(93.8%).ThemeanlengthofMBsegmentswas19.5mm±8.2mm,andthemeandepth1.5mm±0.8mm.Noevidenceofatherosclerosiswasdetectedinthemuralcoronaryartery.Ina2-cm-longsegmentimmediatelyproximalordistaltotheMB,atheroscleroticplaqueswer
7、efoundin75作者簡介:張雪梅(1972-),女,重慶市人,漢族,學(xué)士學(xué)位,主治醫(yī)師,主要從事心血管疾病影像診斷,發(fā)表論文6篇。電話:(023)68765419,E-mail:yuyu20050730@tom.com(38.5%),including66proximalsegments(33.8%)and9distalsegments(4.6%)Thepatientageinthegroupwithatherosclerosiswassignificantlyhigherthaninthegroupwithoutatherosclerosis.Nosign