CAJ | 학술논문

目的：利用双源CT（DSCT）探讨壁冠状动脉（MCA）收缩期的狭窄程度与心肌桥（MB）的长度及厚度间的相关关系。方法应用DSCT对450例可疑冠心病（ CHD）和部分体检者行冠状动脉CTA，2名CT诊断医师独立判断MB－MCA的存在，结果一致时确定为MB－MCA。测量MB长度、厚度，结果用xˉ±s表示。以每隔5％R－R间期为1个重建时相，观察并测量MCA在整个心动周期中管径的变化，探索管径最大和最小时的时相显示规律，计算MCA最大狭窄程度，应用Pearson相关统计分析狭窄程度与MB的长度及厚度之间的相关关系。结果450例可疑CHD和体检者，冠状动脉CTA发现MB－MCA 163例（36．2％），192处。在选取的被心肌完全包绕或覆盖的30例MB－MCA中， MCA收缩期管径最小时出现于R－R间期30％～35％者27例（90．0％），MCA舒张期管径最大时出现于R－R间期70％～80％者27例（90．0％）。统计学结果显示，MCA管腔狭窄程度与MB的厚度呈明显相关（r＝0．675，P＜0．01），而与MB的长度无明显相关性（r＝0．096，P＞0．05）。结论 DSCT冠状动脉成像MCA管径最小和最大时一般分别出现于R－R间期30％～35％和70％～80％处；MCA收缩期狭窄程度与MB的厚度呈明显相关，而与MB的长度无明显相关。
목적：이용쌍원CT（DSCT）탐토벽관상동맥（MCA）수축기적협착정도여심기교（MB）적장도급후도간적상관관계。방법응용DSCT대450례가의관심병（ CHD）화부분체검자행관상동맥CTA，2명CT진단의사독립판단MB－MCA적존재，결과일치시학정위MB－MCA。측량MB장도、후도，결과용xˉ±s표시。이매격5％R－R간기위1개중건시상，관찰병측량MCA재정개심동주기중관경적변화，탐색관경최대화최소시적시상현시규률，계산MCA최대협착정도，응용Pearson상관통계분석협착정도여MB적장도급후도지간적상관관계。결과450례가의CHD화체검자，관상동맥CTA발현MB－MCA 163례（36．2％），192처。재선취적피심기완전포요혹복개적30례MB－MCA중， MCA수축기관경최소시출현우R－R간기30％～35％자27례（90．0％），MCA서장기관경최대시출현우R－R간기70％～80％자27례（90．0％）。통계학결과현시，MCA관강협착정도여MB적후도정명현상관（r＝0．675，P＜0．01），이여MB적장도무명현상관성（r＝0．096，P＞0．05）。결론 DSCT관상동맥성상MCA관경최소화최대시일반분별출현우R－R간기30％～35％화70％～80％처；MCA수축기협착정도여MB적후도정명현상관，이여MB적장도무명현상관。
Objective To investigate the correlation between the percentage of systolic stenosis of the mural coronary artery ( MCA ) and the length and depth of the myocardial bridge using dual-source computed tomography ( DSCT) .Methods Four hundred and fifty patients suspected of coronary artery disease (CHD) underwent dual-source computed tomography coronary angiography (DSCTCA).The images were analyzed by 2 radiologists independently.When consistency was obtained among the independent results, the diagnosis of MB-MCA could be confirmed.The length of MCA and depth of MB were measured. All data were reconstructed by every 5%R-R interval, the diameters of MCAs during the whole cardiac cycle were reviewed and measured, the phases were detected when the diameters of MCAs were maximal and minimal, the systolic stenosis rate of MCA was calculated,Pearson correlation analysis was used to analyze the relation between length, depth, and degree of systolic stenosis of the MCAs.Results One hundred and ninety-two sites of MB-MCA were found in 163 ( 36.2%) of 450 patients.Of the 192 sites, 72 were completely surrounded by myocardium.Among the 30 MCA sites chosen from these 72 sites, the minimal diameters were found at 30%—35% R-R reconstruction interval in 27 sites ( 90.0%) , and the maximal diameters were found at 70%—80% R-R reconstruction interval in 27 sites ( 90.0%) . A significant correlation was not found between systolic stenosis and the length of the MB (r=0.096, P>0.05) but was found with the depth of the MB ( r =0.675, P <0.01 ) of the MCA.Conclusion The minimal and maximal diameters of the MCA usually emerged in 30%—35%R-R reconstruction interval and 70%—80%R-R reconstruction interval on DSCTCA, respectively.The degree of systolic stenosis of MCA significantly correlates with MB depth but not length.