Memisoglu Esat, Hobikoglu Gultekin, Tepe M Savas, Norgaz Tugrul, Bilsel Tuba
Test Cardiovascular Imaging, Istanbul, Turkey.
Catheter Cardiovasc Interv. 2005 Sep;66(1):34-42. doi: 10.1002/ccd.20444.
The objective of this study was to compare the anatomic course of anomalous coronary arteries by axial and three-dimensional volume-rendered electron beam computed tomography (EBCT) angiography and X-ray catheter angiography (CAG). We performed a blinded study where patients who previously underwent CAG with (n = 14) and without (n = 14; age- and gender-matched controls) anomalous coronary anatomy were studied with EBCT coronary angiography. Forty to 50 EKG-triggered 3 mm overlapping axial slices were acquired with 2 mm table movement within one breath hold during the i.v. injection of 140 cc of nonionic iodinated contrast (4 ml/sec). The axial source images and volume-rendered three-dimensional reconstructions were evaluated for the presence, type, and course of coronary anomalies and the results were compared to those of CAG. All normal and anomalous coronary arteries were identified by both modalities in all subjects. Identified anomalies include single coronary artery (n = 3), left-sided right coronary artery (n = 3), right-sided left main coronary artery (n = 3), anterior descending coronary artery (n = 2), circumflex coronary artery (n = 2), and separate left-sided ostia for left anterior descending and circumflex coronary arteries (n = 1). In five cases, there was discrepancy in the course of the anomalous vessels between the two modalities. Consensus reading among cardiologist and radiologists favored the interpretation of EBCT over catheter angiography. Noninvasive EBCT coronary angiography compares well with CAG in identifying anomalous coronary arteries and may provide confirmatory evaluation of their precise anatomic relationships to the heart and great vessels.
本研究的目的是通过轴向和三维容积再现电子束计算机断层扫描（EBCT）血管造影以及X射线导管血管造影（CAG）来比较异常冠状动脉的解剖走行。我们进行了一项盲法研究，对先前接受过CAG检查的有（n = 14）和无（n = 14；年龄和性别匹配的对照组）异常冠状动脉解剖结构的患者进行EBCT冠状动脉血管造影研究。在静脉注射140 cc非离子型碘化造影剂（4 ml/秒）期间，在一次屏气过程中，以2 mm的床移动获取40至50层3 mm重叠的EKG触发轴向切片。评估轴向源图像和容积再现三维重建以确定冠状动脉异常的存在、类型和走行，并将结果与CAG的结果进行比较。在所有受试者中，两种方法均识别出了所有正常和异常的冠状动脉。识别出的异常包括单冠状动脉（n = 3）、左侧右冠状动脉（n = 3）、右侧左主冠状动脉（n = 3）、前降支冠状动脉（n = 2）、回旋支冠状动脉（n = 2）以及左前降支和回旋支冠状动脉的左侧开口分开（n = 1）。在5例病例中，两种方法对异常血管走行的判断存在差异。心脏病专家和放射科医生的共识解读更倾向于EBCT而非导管血管造影的解释。无创性EBCT冠状动脉血管造影在识别异常冠状动脉方面与CAG具有良好的可比性，并且可能对其与心脏和大血管的确切解剖关系提供确证性评估。
