Yang Li, Zhao Lin-fen, Li Ying, Wang Xin-jiang, Zhao Xi-hai, Zhao Shao-hong, Zhao Hong, Wu Jian, Liu Xin, Cai Zu-long
Department of Radiology, General Hospital of PLA, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2006 Oct 31;86(40):2858-62.
To investigate the diagnosis of myocardial bridge and mural coronary artery (MB-MCA) with multi-slice computed tomography (MSCT) and clinical significance thereof.
900 patients suspected as with coronary artery disease (CHD) underwent 64-slice computed tomography performed by 3 radiologists independently. When consistency was obtained among the independent interpretations of the tomogram among them the diagnosis of MB-MCA could be confirmed. The length of MCA and thickness of MB were measured, and the situation of the nearby arteries were observed and recorded. Based on the above mentioned 3 items the reference scoring criteria were established.
180 sites of MB-NCA were found in 167 (18.56%) of the 900 patients, 112 males and 55 females, aged 54.46 (33 - 84). 167 of the 180 sites of MB-MCA were located on the LAD (92.7%). MCA could be covered by MB in a form of semi-circularity (63.89%, 115/180) or circularity (36.11%, 65/180) The length of MCA was 18.7 mm +/- 10.2 mm, and the thickness of MB was 1.7 mm +/- 1.2 mm. 70% of the arteries proximal and/or distal to the MB-MCA were tortuous. Length of MCA < 10 mm, half-surrounding of MB, and smoothness of the proximal and distant vessels were scored as 1; length of MCA of 10 approximately 20 mm, thickness of MB < 1 mm, and tortuousness of the unilateral proximal or distant vessel were scored as 2; and length of MCA > 20 mm, thickness of MB > 1 mm, and tortuousness of the bilateral proximal and distant vessels were scored as 3. Coronary atherosclerosis was found in 88 of the 167 patients (52.69%). No significant correlation was found between coronary atherosclerosis and MB-MCA grade (u = 1.234, P > 0.05).
Sixty-four-slice CT can be used to confirm the presence of MB = MCA and the morphology of coronary artery with MB-MCA. Coronary atherosclerosis is not significantly correlated with MB-MCA grade.
探讨多层螺旋CT（MSCT）对心肌桥及壁冠状动脉（MB-MCA）的诊断及其临床意义。
900例疑似冠心病（CHD）患者由3名放射科医师独立进行64层CT检查。当他们对断层图像的独立解读取得一致意见时，MB-MCA的诊断得以确认。测量MCA的长度和MB的厚度，并观察和记录附近动脉的情况。基于上述3项内容建立参考评分标准。
900例患者中有167例（18.56%）发现180处MB-NCA，其中男性112例，女性55例，年龄54.46岁（33 - 84岁）。180处MB-MCA中的167处位于前降支（LAD，92.7%）。MCA可被MB以半圆形（63.89%，115/180）或圆形（36.11%，65/180）形式覆盖。MCA长度为18.7 mm±10.2 mm，MB厚度为1.7 mm±1.2 mm。MB-MCA近端和/或远端70%的动脉迂曲。MCA长度<10 mm、MB半环绕以及近端和远端血管光滑评分为1分；MCA长度10～20 mm、MB厚度<1 mm以及单侧近端或远端血管迂曲评分为2分；MCA长度>20 mm、MB厚度>1 mm以及双侧近端和远端血管迂曲评分为3分。167例患者中有88例（52.69%）发现冠状动脉粥样硬化。冠状动脉粥样硬化与MB-MCA分级之间未发现显著相关性（u = 1.234，P>0.05）。
64层CT可用于确认MB = MCA的存在及伴有MB-MCA的冠状动脉形态。冠状动脉粥样硬化与MB-MCA分级无显著相关性。
