| 戴沁怡,张兆琪,吕飙,王瑞.多层螺旋CT血管成像诊断冠状动脉瘘[J].中国医学影像技术,2011,27(3):537~540 |
| 多层螺旋CT血管成像诊断冠状动脉瘘 |
| Diagnosis of coronary artery fistula with multi-detector computed tomography angiography |
| 投稿时间：2010-09-30 修订日期：2010-12-08 |
| DOI： |
| 中文关键词: 冠状血管 瘘 体层摄影术,X线计算机 |
| 英文关键词:Coronary vessels Fistula Tomography, X-ray computed |
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| 中文摘要: |
| 目的 评价冠状动脉瘘(CAF)的多层螺旋CT血管造影(MDCTA)特点及其诊断价值。方法 回顾性分析21例接受回顾性心电门控冠状动脉MDCTA的CAF患者影像资料,经VR、MPR、MIP、CPR后确定诊断。结果 ①瘘支动脉中,单一瘘管12例,其中起自右冠状动脉4例、左冠状动脉8例;多发瘘管9例;16例瘘口引流至肺动脉、2例至右心房,2例至左心室、1例至左心房;②瘘支动脉表现为扩张、纡曲或仅为血管丛状,2例合并动脉瘤,合并心包积液、左心室室壁瘤各1例,均未合并心内畸形;③3例失访,1例死亡,17例经超声心动图检查,5例漏诊;17例经冠状动脉造影证实,7例接受手术治疗。结论 MDCTA可无创而准确地显示CAF 起源、行程、引流部位及合并异常。 |
| 英文摘要: |
| Objective To observe the characteristics and diagnostic value of coronary artery fistula (CAF) with multi-detector CT angiography (MDCTA). Methods Images of 21 CAF patients who underwent MDCTA using retrospective ECG gating were analyzed. VR, MPR, MIP, CPR were performed for diagnosis of CAF. Results ①Unilateral fistula was detected in 12 patients, including fistula arising from the right coronary artery in 4 patients, from the left coronary artery in 8 patients, while multiple fistulas were found in 9 patients. Pulmonary artery was the most common site of drainage (n=16), followed by the right atrium (n=2), the left ventricle (n=2), and the left atrium (n=1). ②The involved arteries manifested as dilatation, anfractuosities or vascular plexus, in which 2 cases complicated with aneurysm, 1 case combined with pericardial effusion, 1 case with left ventricular aneurysm. No cardiac malformation was detected. ③Seventeen patients survived, 3 were lost in follow-up, while 1 patient died. Missed diagnosis happened in 5 of 17 patients who underwent echocardiography. CAF was verified in 17 patients with coronary angiography, among which 7 were treated with operation. Conclusion MDCTA is an ideal noninvasive technique for observation on the origin, course, terminal point of CAF and coexistent abnormalities. |
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