实用医学影像杂志
實用醫學影像雜誌
실용의학영상잡지
JOURNAL OF PRACTICAL MEDICAL IMAGING
2014年
5期
352-355
,共4页
体层摄影术,螺旋计算机%心电描记术%心肌桥%冠状血管
體層攝影術,螺鏇計算機%心電描記術%心肌橋%冠狀血管
체층섭영술,라선계산궤%심전묘기술%심기교%관상혈관
Tomography,spiral computed%Electriocardiography%Myocardial bridging%Coronary vessels
目的：探讨64层螺旋CT诊断心肌桥-壁冠状动脉（MB-MCA）的相关性研究。方法回顾154例MB-MCA患者的影像资料，用双时相冠状动脉重建结合多平面重建（MPR）、容积再现（VR）、最大密度（MIP）投影技术测量MB-MCA，对比分析其结果、临床症状及心电图ST-T改变的差异。结果 MB-MCA多发生于前降支（116例占75．3％），MB厚度0．51~4．6 mm，平均1．25 mm。长为1．2~5．1 mm，平均2．47 mm。其中75％时相MCA狭窄106段，狭窄程度25％~65％；45％时相MCA狭窄154段，狭窄程度32％~82％。48例未见血管硬化及狭窄征象；106例管腔伴有不同程度的粥样硬化斑块和狭窄，以前降支近段、中段多见。管腔狭窄＜50％者126例（81．8％）；钙化斑块伴狭窄＜50％36例、≥50％12例；软斑块23例狭窄＜50％；混合斑块35例（其中狭窄＜50％20例、≥50％15例）。不同时相管腔狭窄程度与临床症状、心电图ST-T段改变有明显相关性。结论64层CT双时相重建对MB-MCA检出率高，但仍有一定局限性，对不同心动周期时MB-MCA的动态变化不了解。 MB发生部位、厚度与临床症状、心电图ST-T改变有一定的相关性，与MCA长度可能无明显相关。
目的：探討64層螺鏇CT診斷心肌橋-壁冠狀動脈（MB-MCA）的相關性研究。方法迴顧154例MB-MCA患者的影像資料，用雙時相冠狀動脈重建結閤多平麵重建（MPR）、容積再現（VR）、最大密度（MIP）投影技術測量MB-MCA，對比分析其結果、臨床癥狀及心電圖ST-T改變的差異。結果 MB-MCA多髮生于前降支（116例佔75．3％），MB厚度0．51~4．6 mm，平均1．25 mm。長為1．2~5．1 mm，平均2．47 mm。其中75％時相MCA狹窄106段，狹窄程度25％~65％；45％時相MCA狹窄154段，狹窄程度32％~82％。48例未見血管硬化及狹窄徵象；106例管腔伴有不同程度的粥樣硬化斑塊和狹窄，以前降支近段、中段多見。管腔狹窄＜50％者126例（81．8％）；鈣化斑塊伴狹窄＜50％36例、≥50％12例；軟斑塊23例狹窄＜50％；混閤斑塊35例（其中狹窄＜50％20例、≥50％15例）。不同時相管腔狹窄程度與臨床癥狀、心電圖ST-T段改變有明顯相關性。結論64層CT雙時相重建對MB-MCA檢齣率高，但仍有一定跼限性，對不同心動週期時MB-MCA的動態變化不瞭解。 MB髮生部位、厚度與臨床癥狀、心電圖ST-T改變有一定的相關性，與MCA長度可能無明顯相關。
목적：탐토64층라선CT진단심기교-벽관상동맥（MB-MCA）적상관성연구。방법회고154례MB-MCA환자적영상자료，용쌍시상관상동맥중건결합다평면중건（MPR）、용적재현（VR）、최대밀도（MIP）투영기술측량MB-MCA，대비분석기결과、림상증상급심전도ST-T개변적차이。결과 MB-MCA다발생우전강지（116례점75．3％），MB후도0．51~4．6 mm，평균1．25 mm。장위1．2~5．1 mm，평균2．47 mm。기중75％시상MCA협착106단，협착정도25％~65％；45％시상MCA협착154단，협착정도32％~82％。48례미견혈관경화급협착정상；106례관강반유불동정도적죽양경화반괴화협착，이전강지근단、중단다견。관강협착＜50％자126례（81．8％）；개화반괴반협착＜50％36례、≥50％12례；연반괴23례협착＜50％；혼합반괴35례（기중협착＜50％20례、≥50％15례）。불동시상관강협착정도여림상증상、심전도ST-T단개변유명현상관성。결론64층CT쌍시상중건대MB-MCA검출솔고，단잉유일정국한성，대불동심동주기시MB-MCA적동태변화불료해。 MB발생부위、후도여림상증상、심전도ST-T개변유일정적상관성，여MCA장도가능무명현상관。
Objective To study the correlation research of 64-slice CT in diagnosis of myocardial bridge -coronary arteries. Methods Review the imaging data of 154 patients with MB-MCA, using double phase coronary reconstruction combined with multi planar reconstruction (MPR) , volume rendering (VR),maximum intensity projection (MIP) technique for the measurement of MB-MCA. Comparatively analyze the difference between the result,clinical symptoms and ECG ST-T changes. Results MB-MCA occurred in the anterior descending artery (116 cases, 75.3%) , the thickness of MB was 0.51-4.6 mm,with the average of 1.25 mm,the length was 1.2-5.1mm,with the average of 2.47 mm. In the 75% phase,stenosis had 106 segments,the degree of stenosis was 25%-65%. In the 45% phase, stenosis had 154 segments,the degree of stenosis was 32%-82%. Forty-eight cases had no signs of narrowing and hardening of the arteries; 106 cases with varying degrees of luminal atherosclerotic plaque and stenosis. Which often occuered in the anterior descending branch proximal middle segment. There were 126 patients with stenosis over 50%(81.8%), Calcified plaque with stenosis of less than 50% were detected in 36 cases and 12 patients over 50%. Soft plaque caused stenosis of less than 50% were seen in 23 cases ,35 patients with mixed plaque (where 20 cases with stenosis less than 50% ,15 cases over 50%). Different time stenosis and clinical symptoms , ECG ST-T segment changes had a significant correlation. Conclusion The detection rate of 64-slice CT is high in the reconstruction of the MB-MCA,but still has certain limitations. They cannot distinguish the dynamic changes of difference heart beat cycle.The location ,thickness of MB has certain correlation with the clinical symptoms and electrocardiogram ST-T change.But there is no obvious correlation with the length of MCA.
