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目的探讨多层CT冠状动脉血管成像检查患者中心肌桥的特征及临床意义。方法临床确诊冠心病或疑似冠心病而行多层螺旋CT冠状动脉血管成像检查的病例875例,男579例,女296例,年龄30~87岁,平均60岁。采用回顾性心电门控扫描,心率>75次/min,重建相位区间为30%～40%,心率<75次/min,重建相位区间为40%～50%,获得最大密度投影、曲面重组、容积重组图像,从多角度显示左、右冠状动脉主干及其各主要分支。结果检出89例心肌桥患者,检出率10.2%。其中36例(40.5%)管腔呈不同程度的狭窄(<50%)。发生于前降支中段者71例(79.8%),肌桥厚度0.06～0.55cm,其中20例近段伴有不同程度的粥样硬化斑块,管腔狭窄均接近50%。单纯心肌桥患者有心绞痛症状者39例,心肌桥伴有冠状动脉粥样硬化者有心绞痛症状23例。结论MSCT冠状动脉血管成像可以明确检出心肌桥,为临床的诊断和治疗提供了更具价值的信息。
Objective To investigate the characteristics and clinical significance of myocardial bridge in patients with multi-slice CT coronary angiography. Methods 875 cases of coronary artery angiography with multi-slice spiral CT were diagnosed clinically or suspected coronary heart disease. There were 579 males and 296 females, aged 30-87 years, with an average of 60 years. Retrospective ECG gated scanning, heart rate> 75 beats / min, reconstructed phase range of 30% to 40%, heart rate <75 beats / min, reconstruction phase interval of 40% to 50%, to obtain the maximum density projection, Volumetric reconstructed images show the left and right coronary arteries and their major branches from multiple perspectives. Results 89 patients with myocardial bridge were detected, the detection rate was 10.2%. Among them, 36 cases (40.5%) had different degrees of stenosis (<50%). 71 cases (79.8%) occurred in the middle part of anterior descending artery, and the thickness of muscular bridge was 0.06 ~ 0.55cm. Among them, 20 cases were accompanied by different degree of atherosclerotic plaque and the stenosis of lumen was close to 50%. There were 39 cases of angina pectoris in patients with simple myocardial bridge, 23 cases of angina pectoris in patients with myocardial bridge accompanied by coronary atherosclerosis. Conclusion MSCT coronary angiography can clearly detect the myocardial bridge, which provides more valuable information for clinical diagnosis and treatment.