左冠状动脉主干高位开口及冠状动脉前降支肺动脉瘘的心肌首过灌注初步研究

发布时间：2018-07-16 16:25

【摘要】：目的比较单纯性左冠状动脉主干高位开口及冠状动脉前降支肺动脉瘘患者与正常对照组心肌首过灌注的差异。方法搜集2013年1月至9月左冠状动脉前降支肺动脉瘘6例,单纯性左冠状动脉主干高位12例,采用多层螺旋CT血管成像(MSCTA)行轴位扫描,应用东芝后处理工作站进行前降支供血区心肌首过灌注分析,将单纯性左冠状动脉主干高位、左冠状动脉前降支肺动脉瘘与正常组冠状动脉的舒张期和收缩期心肌灌注校正值(c-MP)进行比较,分析冠状动脉变异对心肌首过灌注的影响。结果冠状动脉前降支肺动脉瘘舒张期和收缩期c-MP值均低于正常组;单纯性的左冠状动脉主干高位与正常组的收缩期和舒张期的c-MP值无明显差异。结论冠状动脉前降支肺动脉瘘的首过灌注效应的初步性研究,在一定程度上反映冠状动脉前降支瘘的供血区情况,冠状动脉前降支肺动脉瘘的患者舒张期和收缩期的c-MP值均减低,当存在前降支肺动脉瘘时,前降支支配区心肌的首过灌注减低,是患者发生心肌缺血的潜在原因之一。
[Abstract]:Objective to compare the difference of myocardial first-pass perfusion between patients with simple left coronary artery high opening and anterior descending coronary artery pulmonary artery fistula and normal control group. Methods from January to September 2013, 6 cases of left anterior descending artery pulmonary artery fistula and 12 cases of simple left coronary artery trunk high position were collected. Toshiba postprocessing workstation was used to analyze the myocardial first-pass perfusion in the anterior descending branch. The left anterior descending branch pulmonary artery fistula was compared with normal coronary artery diastolic and systolic myocardial perfusion correction values (c-MP) to analyze the effect of coronary artery variation on myocardial first-pass perfusion. Results the values of c-MP in diastolic and systolic phase of anterior descending coronary artery fistula were lower than those in normal group, but there was no significant difference between the high left coronary artery and normal coronary artery. Conclusion the primary study on the first-pass perfusion effect of anterior descending coronary artery pulmonary artery fistula reflects to some extent the blood supply area of anterior descending coronary artery fistula. In patients with anterior descending coronary artery pulmonary artery fistula, c-MP in diastolic phase and systolic phase were decreased. When there was anterior descending artery pulmonary artery fistula, the first-pass perfusion of anterior descending artery was decreased, which was one of the potential causes of myocardial ischemia in patients with anterior descending branch pulmonary artery fistula.
【作者单位】：江苏省人民医院放射科;武汉协和医院放射科;
【基金】：国家自然科学基金资助项目(编号:81271570)
【分类号】：R543.3;R816.2

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