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目的研究心脏冠脉CTA在心肌桥-壁冠状动脉(MB-MCA)临床诊断中的意义。方法回顾分析2014年5月至2015年10月671例行冠状动脉CTA检查患者的临床资料,所有患者均采用64排128层螺旋CT进行冠脉造影,由两名高年资放射科医师进行图像采集和分析,诊断是否有心肌桥,对心肌桥的病变位置、长度、深度等进行评估,对心肌桥-壁冠状动脉管腔狭窄程度进行判断。结果 671例患者中共检查出心肌桥患者268例,占所有患者的39.94%。其中心肌桥-壁冠状动脉管腔狭窄患者46例,占心肌桥患者的17.16%。平均长度为(19.7±8.1)mm,深度为(1.6±0.2)mm。心肌桥位于前降支中段比为78.64%,比较心肌桥组与无心肌桥组对应节段斑块发生率及狭窄程度,差异具统计学意义(P<0.05)。结论冠脉CTA可用于评价心肌桥的结构及特征,能准确显示壁冠状动脉与心肌的解剖关系,是一种有效、无创的方法,在心肌桥诊断过程中有较高的临床意义。
Objective To investigate the significance of cardiac coronary artery CTA in the clinical diagnosis of myocardial bridge-wall coronary artery (MB-MCA). Methods The clinical data of 671 coronary artery CTA patients from May 2014 to October 2015 were retrospectively analyzed. All patients underwent 64-row 128-slice spiral CT for coronary angiography. Two senior radiologists performed images Acquisition and analysis, diagnosis of myocardial bridge, the location of the myocardial bridge lesion, length, depth, etc., to assess myocardial stenosis - wall coronary artery stenosis. Results A total of 268 patients with myocardial bridge were detected in 671 patients, accounting for 39.94% of all patients. Among them, 46 cases of myocardial bridge - wall coronary artery stenosis, accounting for 17.16% of patients with myocardial bridge. The average length was (19.7 ± 8.1) mm and the depth was (1.6 ± 0.2) mm. Myocardial bridge in the middle part of the anterior descending artery ratio was 78.64%, compared with myocardial bridge group and non-myocardial bridge group corresponding segment plaque incidence and stenosis, the difference was statistically significant (P <0.05). Conclusion Coronary CTA can be used to evaluate the structure and characteristics of myocardial bridge and accurately display the anatomic relationship between the wall coronary artery and myocardium. It is an effective and noninvasive method and has a high clinical significance in the diagnosis of myocardial bridge.