摘要
目的探讨MSCT在合并壁冠状动脉的心肌缺血中的临床应用价值。方法 9例心肌缺血患者进行MSCT冠状动脉成像,采用回顾性心电门控技术重建,并结合三维重组图像观察冠状动脉,采用MPR重组观察左心室短轴、水平长轴切面、垂直长轴切面各段心肌灌注情况。结果同时存在壁冠状动脉及相应供血区心肌缺血患者共9例,全部位于左前降支,其中壁冠状动脉舒张期狭窄超过50%4例,舒张期狭窄小于50%5例。心肌缺血部位位于心尖部6例,室间隔壁2例,前壁1例;增强扫描缺血区早期呈小片状、线状低密度灌注缺损。结论 MSCT不仅可以显示心肌与冠状动脉间的解剖关系,而且能够同时显示心肌灌注的情况,在心肌桥-壁冠状动脉的诊断、鉴别诊断和预后评估中有着重要的作用,可以作为首选检查。
Objective To evaluate the clinical value of MSCT in the diagnosis of myocardial ischemia with mural coronary artery. Methods Nine cases with myocardial ischemia were performed by MSCT coronary artery angiography. The coronary arteries were observed using retrospective ECG-gated reconstruction and combining with threedimensional reconstructive images, and the regional myocardial perfusion were analyzed by MPR in the cross-section of the short axis, horizontal and vertical long axis of the left ven tricle. Results Mural coronary artery in 9 patients coexisted with the corresponding myocardial ischemia. All the mural coronary arteries were located in the left anterior descending branch, which stenosis were greater than 50% during diastolic period in 4 cases, and less than 50% in 5 cases. Myocardial ischemia were found in the apical area in 6 cases, ventricular septal wall in 2 cases and anterior wall in 1 case, which showed small patchy or striped low-density perfusion defects in the early enhanced scans. Conclusion MSCT can display not only the anatomical relationship between cardiac muscle and coronary artery, but also the myocardial perfusion, which plays an important role in the diagnosis, differential diagnosis and prognosis assessment of myocardial bridge mural coronary artery, so it can be used as the ideal examination method.
出处
《中国CT和MRI杂志》
2010年第3期8-11,共4页
Chinese Journal of CT and MRI
基金
深圳市科技计划非资助项目(200802011)
