CTA诊断冠状动脉异常起源肺动脉

发布时间：2018-01-20 17:00

  本文关键词： 冠状血管 体层摄影术 X线计算机 异常起源 肺动脉　出处：《中国医学影像技术》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨冠状动脉(简称冠脉)异常起源肺动脉(ACAPA)的CTA图像特征。方法回顾性分析本院收治的24例ACAPA的患者资料,分析其CTA表现,并与手术结果对照。结果 24例患者中,发生于左冠脉20例(20/24,83.33%)、右冠脉1例(1/24,4.17%)、前降支1例(1/24,4.17%)、回旋支2例(2/24,8.33%)。冠脉异常起源部位:起源于肺动脉窦或肺动脉主干后壁11例(11/24,45.83%)、左壁7例(7/24,29.17%)、右壁4例(7/24,16.67%),起源于左肺动脉2例(2/24,8.33%)。侧支循环:婴儿型5例,冠脉间未见侧支血管;成人型19例,其中左/右冠脉异常起源16例,前降支异常起源1例,回旋支异常起源2例。合并双前降支和冠脉在升主动脉壁内走行各1例。外科手术19例。术后CTA复查5例,1例人工管道与回旋支吻合口局限性狭窄,1例右心室流出道再狭窄,1例冠脉假性动脉瘤。结论 CTA可清晰显示冠脉异常起源部位、与升主动脉的距离、侧支血管、合并其他冠脉畸形,有助于术前制定手术方式及术后随访。
[Abstract]:Objective to investigate the CTA features of the anomalous origin of coronary artery (CAPA) in pulmonary artery. Methods the data of 24 patients with ACAPA treated in our hospital were retrospectively analyzed. The CTA findings were analyzed and compared with the surgical results. Results among the 24 patients, 20 cases occurred in the left coronary artery, 20% in the left coronary artery, 83.33% in the left coronary artery, 1 case in the right coronary artery, and 1 case in the right coronary artery. The anterior descending branch (1 / 1 / 24 / 4.17), the circumflex branch (2 / 2 / 248.33), the origin of the abnormal coronary artery (11 / 24) originated from the pulmonary sinus or the posterior wall of the main pulmonary artery (11 / 24). 45.83%, 7 cases on the left wall and 29.17% on the left wall, 4 cases on the right wall, 7 / 24% on the right wall and 16.67% on the right wall, which originated from the left pulmonary artery in 2 cases (2 / 24). 8.33 collateral circulation: there were 5 cases of infantile type with no collateral vessels between the coronary arteries. There were 19 cases of adult type, including 16 cases of abnormal origin of left / right coronary artery and 1 case of abnormal origin of anterior descending branch. There were 2 cases of abnormal origin of circumflex branch, 1 case of double anterior descending branch and 1 case of coronary artery walking in ascending aortic wall, 19 cases of surgical operation, and 1 case of local stenosis of anastomotic stoma between artificial conduit and circumflex branch in 5 cases after CTA. One case with right ventricular outflow tract restenosis and one case with pseudoaneurysm of coronary artery. Conclusion CTA can clearly show the origin of the abnormal coronary artery, the distance from the ascending aorta, the collateral vessels, and other coronary malformations. It is helpful to establish the operation method before operation and follow up after operation.
【作者单位】： 武汉亚洲心脏病医院放射科;
【分类号】：R543.3;R816.2
【正文快照】： 冠状动脉异常起源肺动脉(anomalous origin ofcoronary artery from the pulmonary artery,ACA-PA)是一种罕见的冠状动脉(简称冠脉)先天畸形,即冠脉的主干或分支未从主动脉发出,而从肺动脉窦或肺动脉发出,属冠脉恶性起源异常;可发生于左冠脉(ALCAPA)、右冠脉(ARCAPA)、前降支，

本文编号：1448977