CAJ | 학술논문

目的：探讨64排螺旋CT冠状动脉成像（CAG）在诊断心肌桥（MB）-壁冠状动脉（MCA）中的应用价值。方法对436例在北京市普仁医院接受64排螺旋CT CAG患者的影像资料进行回顾性分析。对MB-MCA检出率及患者临床表现、MB所在位置，以及各支发生率，MB的长度、厚度与 MCA狭窄程度的关系按是否存在MB进行分组配对，比较MB-MCA组和无MB-MCA组动脉粥样硬化发生率的差异。结果436例患者中76例发现MB（17．4％，76/436）。左前降支（LAD）段发生率最高（68．4％，52/76）。MCA狭窄程度与MB长度和厚度相关。LAD-MB-MCA组和无MB-MCA组比较，在冠状动脉斑块是否存在方面及在冠状动脉斑块引起MCA管腔不同程度狭窄方面，差异均有统计学差异（P＜0．05）。结论64排螺旋CT CAG能准确显示MB与MCA的解剖关系，是初筛MB-MCA的一种优良诊断方法。MCA的狭窄程度与MB的长度、厚度相关。MB-MCA的存在和严重的狭窄程度意味着邻近LAD段的冠状动脉更易形成动脉粥样硬化斑块。
목적：탐토64배라선CT관상동맥성상（CAG）재진단심기교（MB）-벽관상동맥（MCA）중적응용개치。방법대436례재북경시보인의원접수64배라선CT CAG환자적영상자료진행회고성분석。대MB-MCA검출솔급환자림상표현、MB소재위치，이급각지발생솔，MB적장도、후도여 MCA협착정도적관계안시부존재MB진행분조배대，비교MB-MCA조화무MB-MCA조동맥죽양경화발생솔적차이。결과436례환자중76례발현MB（17．4％，76/436）。좌전강지（LAD）단발생솔최고（68．4％，52/76）。MCA협착정도여MB장도화후도상관。LAD-MB-MCA조화무MB-MCA조비교，재관상동맥반괴시부존재방면급재관상동맥반괴인기MCA관강불동정도협착방면，차이균유통계학차이（P＜0．05）。결론64배라선CT CAG능준학현시MB여MCA적해부관계，시초사MB-MCA적일충우량진단방법。MCA적협착정도여MB적장도、후도상관。MB-MCA적존재화엄중적협착정도의미착린근LAD단적관상동맥경역형성동맥죽양경화반괴。
Objective To evaluate the application value of 64-row spiral CT coronary angiography(CAG)in myocardial bridge (MB)and mural coronary artery(MCA) .Methods Imaging data of 436 consecutive subjects underwent coronary CT angiography in Hospital of Beijing Puren were enrolled in this study .The prevalence ,clinical effects of patients ,precise location and incidence of each branch were evaluated .In addition ,the length and depth of MB ,as well as their relationship with MCA in stenosis were evalua-ted .Moreover ,the group of subjects with MB was compared with the control group(subjects without MB)in the probability of ath-erosclerosis .Results Among the total of 436 subjects ,76 subjects(17 .4% ,76/436)were found to have MB .The left anterior de-scending artery(LAD)was the most common coronary artery involved(68 .4% ,52/76) .The pressure level of MCA associated with the length and depth of MB .A significant difference was found between the LAD-MB-MCA group and the control group in the presence of coronary artery plaques(P<0 .05) .Conclusion The anatomic relation between MB and MCA can be precisely displayed on 64-row spiral CT coronary angiography ,which is considered to be an excellent diagnostic method to screen MB-MCA initially . There is a relationship between stenosis of MCA and the length and depth of MB .The present and stenosis of MB-MCA are meant to form coronary artery plaques in LAD segment more easily .