雙源CT對孤立性心肌橋—壁冠狀動脈的研究

高永炳+龔波+沈丹丹

【摘要】 目的：通過雙源CT冠狀動脈成像，研究孤立性心肌橋-壁冠狀動脈的特性。方法：收集2013年1月-2017年1月在本院進行冠狀動脈CT檢查，僅檢出心肌橋-壁冠狀動脈且無冠狀動脈粥樣硬化癥、冠心病等其他心臟相關疾病的患者數據，根據肌橋的位置、患者性別分組比較，研究分析孤立性心肌橋-壁冠狀動脈的特性。結果：324例檢出孤立性心肌橋-壁冠狀動脈的患者中，男146例，女178例，平均年齡（57.94±10.50）歲。共檢出心肌橋-壁冠狀動脈350處，其中左前降支346處，右冠狀動脈2處，對角支及中間支各1處。患者心肌橋-壁冠狀動脈的發病年齡比較，差異無統計學意義（P>0.05）。檢出肌橋位置以左前降支中段好發，不同肌橋位置的患者性別比較，差異有統計學意義（P<0.05），其中近段心肌橋-壁冠狀動脈以男性患者多見（P<0.05），而中、遠段肌橋患者性別比較，差異均無統計學意義（P>0.05）。此外不同位置的肌橋長度比較，差異有統計學意義（P<0.05），男性患者中、遠段肌橋要長于女性（P<0.05）。心肌橋-壁冠狀動脈類型以表淺型多見，與位置無相關性（P>0.05）。結論：雙源CT冠狀動脈成像對孤立性心肌橋-壁冠狀動脈的位置、長度、壁冠狀動脈類型的診斷有重要意義。

【關鍵詞】 孤立性； 心肌橋-壁冠狀動脈； 雙源CT

【Abstract】 Objective：The characteristics of isolated myocardial bridge mural coronary artery was studied by dual-source CT coronary angiography.Method：Data were collected from patients of coronary CT scan in our hospital from January 2013 to January 2017 that only myocardial bridge mural coronary artery was detected without any coronary atherosclerosis，coronary heart disease and other cardiac-related diseases.Data of each group that according to the location of myocardial bridge and gender of patients were compared，and analyze characteristics of isolated myocardial bridge mural coronary artery.Result：324 cases of isolated myocardial bridge mural coronary artery detected，146 cases were male and 178 were female，the average age was （57.94±10.50） years old.There were 350 sites of myocardial bridge mural coronary arteries were detected，the left anterior descending arteries were 346 sites，the right coronary arteries were 2 sites，the diagonal branch and the middle branch was each of 1 site.The age of onset of the myocardial bridge mural coronary artery in patients was compared，the difference was not statistically significant（P>0.05）.Myocardial bridge occurred more at the middle of the left anterior descending，the different locations in the myocardial bridge of gender was compared，the difference was statistically significant（P<0.05），the proximal segment of myocardial bridge mural coronary artery were more common in male patients（P<0.05），but the middle and distal of myocardial bridge of gender were compared，the differences were not statistically significant（P>0.05）.Additionally，the length of the myocardial bridge at different locations was compared，the difference was statistically significant（P<0.05），the length of the distal myocardial bridge in men was longer than that of women（P<0.05）.Type of mural coronary artery was more common in superficial type and there had no correlation between types and myocardial bridge locations（P>0.05）.Conclusion：Dual-source CT coronary angiography is important for the diagnosis of the location，length and type of isolated myocardial bridge mural coronary artery.endprint

【Key words】 Isolation； Myocardial bridge mural coronary artery； Dual-source CT

First-authors address：Wujin Hospital Affiliated with Jiangsu University，Changzhou 213002，China

doi：10.3969/j.issn.1674-4985.2017.29.004

心肌橋-壁冠狀動脈是一種較常見的血管變異。正常情況下冠狀動脈走行在心臟表面外膜下，若其中一段被心肌纖維包繞并在其中行走一定距離又行至心肌表面，則覆蓋此段血管的心肌稱為心肌橋，而走行于其中的冠狀動脈稱為壁冠狀動脈[1]。孤立性心肌橋-壁冠狀動脈是指僅有心肌橋而無血管粥樣硬化及其他器質性的心臟疾患。隨著CT冠狀動脈成像廣泛運用，不僅為心肌橋-壁冠狀動脈臨床診斷提供了準確方法，也為研究心肌橋影像學特征，指導臨床治療、隨訪提供了新的方法[2-3]。回顧……