右冠状动脉起始部-主动脉夹角变异的64层螺旋CT诊断价值

发布时间：2018-07-04 20:53

本文选题：CTA + 右冠状动脉　；参考：《实用医学杂志》2015年10期

【摘要】：目的:探讨64层多螺旋CT(64-multistage CT,MSCT)对右冠状动脉(right coronary artery,RCA)起始部-主动脉夹角变异的诊断价值。方法:收集我院2012年7月至2014年4月72例行64-MSCT冠状动脉CT造影(multistage CT angiography,MSCTA),诊断为右冠状动脉起始部-主动脉夹角变异患者,对原始图像行多平面重组、最大密度投影、曲面重建、容积再现等后处理重建,测量RCA起始部主动脉夹角,分析夹角变小的形态学特征,观察RCA斑块情况。结果:72例患者根据夹角变异的不同,可分为3类,第1类45例,表现为RCA开口处狭窄,紧贴主动脉行走;第2类14例,表现为右冠状动脉起源于右冠状动脉窦,起始部紧贴冠状动脉窦壁,呈急转角式走行;第3类13例,表现为RCA起源于左冠状动脉窦,并呈埋藏式走行于主动脉与肺动脉-右室流出道之间。MSCTA显示72例患者右冠状动脉起始部-主动脉夹角均不同程度变锐且行程异常;其中60例RCA存在斑块。结论:64-MSCTA能清楚显示右冠状动脉起始部-主动脉夹角及右冠状动脉起始部形态学特征;该夹角变小很可能与冠脉斑块的形成有密切关系;也很可能是形成这种心源性猝死高风险的一个因素。观察该夹角的大小对临床诊治有重要的指导意义。
[Abstract]:Objective: to evaluate the diagnostic value of 64 slice multihelical CT (64-multistage CT) in the variation of the angle between the beginning and aorta of right coronary artery arteriole. Methods: from July 2012 to April 2014, 72 patients underwent 64-MSCT coronary angiography (multistage CT angiographic CT) and were diagnosed as patients with variant angle between right coronary artery and aorta. The original images were reconstructed with multiplanar reconstruction, maximum intensity projection and curved surface reconstruction. Volume reconstruction and other post-processing reconstruction were performed to measure the angle between the aorta at the beginning of RCA and to analyze the morphological features of the reduced angle and to observe the plaques of RCA. Results according to the variation of inclusion angle, 72 patients were divided into three groups, the first group (45 cases) showed that the opening of RCA was narrow and the aorta was close to the aorta, and the second group (14 cases) showed that the right coronary artery originated from the right coronary sinus. The initial part was close to the sinus wall of the coronary artery, with a sharp angle, and the third group of 13 cases showed that the RCA originated from the left coronary sinus. In 72 patients, the angle between the origin of the right coronary artery and the aorta became sharp and abnormal in varying degrees, and 60 of the 72 patients had plaque in RCA. Conclusion the morphological features of the origin of right coronary artery and the origin of right coronary artery can be clearly demonstrated by the ratio 64-MSCTA, which may be closely related to the formation of coronary plaque. It is also likely to be a factor in the high risk of sudden cardiac death. It is important for clinical diagnosis and treatment to observe the size of the angle.
【作者单位】：广东医学院附属医院放射科;
【基金】：湛江市科技计划项目(编号:2013B01215)
【分类号】：R541.4;R816.2

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