论文部分内容阅读
目的总结冠状动脉先天性起源异常的多层CT表现和临床意义。方法回顾性分析4581例冠状动脉CT血管造影(CT angiography,CTA)检查的影像和临床资料,冠状动脉起源异常者41例,男性34例,女性7例,年龄3～81(54.3±15.6)岁。观察CTA横轴位薄层重建图像,再进行多平面重组(multi-planar reconstruction,MPR)、最大密度投影(maximum intensity project,MIP)和容积再现(volume rendering,VR)后处理观察。结果冠状动脉起源异常41例,发生率为0.9%。41例中,右冠状动脉起源于左冠窦9例,高位开口6例;左冠状动脉高位开口4例,左冠状动脉起源于右冠窦3例;左前降支与左旋支分别起源于左冠窦8例,左前降支起源于右冠状动脉2例,左旋支起源于右冠状动脉5例;左右冠状动脉共干起源4例。41例中23例有发作性胸闷、心悸,4例有心绞痛,其中2例有心源性休克。结论多层螺旋CTA可无创性显示冠状动脉起源及走行异常,应作为疑诊冠状动脉起源异常的首选影像学检查方法 。
Objective To summarize the multi-slice CT findings and clinical significance of congenital anomalous coronary arteries. Methods A retrospective analysis of 4581 cases of CT angiography (CT angiography, CTA) examination of the image and clinical data, 41 cases of abnormal coronary origin, 34 males and 7 females, aged 3 to 81 (54.3 ± 15.6) years of age . The transverse CTA reconstructed images were observed and observed by multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) post-treatment. Results Abnormalities of coronary artery in 41 cases, the incidence was 0.9%. Among the 41 cases, the right coronary artery originated from the left coronary sinus in 9 cases and the high position opened in 6 cases. The left coronary artery opened in 4 cases, the left coronary artery originated from the right coronary sinus. The left anterior descending artery and the left circumflex artery originated from the left coronary artery 8 cases of sinus, left anterior descending branch originated in 2 cases of right coronary artery, left circumflex artery originated in 5 cases of right coronary artery; left and right coronary artery in 4 cases. Twenty-three of the 41 patients had episodic chest distress, palpitations, and 4 had angina pectoris, of which 2 had cardiogenic shock. Conclusions Multi-slice CTA can noninvasively show the origin and abnormalities of coronary arteries and should be the first choice of imaging diagnosis for suspected anomalous origin of coronary arteries.