Atar Eli, Kornowski Ran, Fuchs Shmuell, Naftali Noa, Belenky Alexander, Bachar Gil N
Department of Radiology, Rabin Medical Center, Petah Tiqwa 49100, Israel.
J Cardiovasc Comput Tomogr. 2007 Oct;1(2):78-83. doi: 10.1016/j.jcct.2007.08.003. Epub 2007 Aug 14.
Myocardial bridging is a congenital condition in which a segment of an epicardial artery has an intramural course within the myocardium. The aim of the present study was to evaluate the prevalence of myocardial bridging and the ability of 64-slice coronary computed tomography angiography to identify myocardial bridging in asymptomatic adults.
One hundred sixty-nine consecutive asymptomatic subjects underwent 64-row multidetector computed tomography (MDCT) of the coronary arteries. Two experienced CT radiologists identified myocardial bridging >1 mm in thickness, by consensus. We examined the frequency of myocardial bridging and evaluated the length, thickness, and coronary wall lesions.
Myocardial bridges were found in 28 (17%) of 165 subjects. Twenty-one subjects (75%) had 1 bridge and 7 subjects (25%) had 2, for a total of 35 myocardial bridges. Twenty-one bridges (60%) were located in the left anterior descending, 8.5% in the diagonal branch, and 2.8% in the circumflex arteries. The segment beneath the myocardial bridge was always free of coronary wall plaques, but the arterial segment proximal to it had significant coronary wall plaques in 24 cases (68.6%).
We found that the incidence of myocardial bridging in asymptomatic adults is 7%, which is in agreement with some pathologic studies in the literature. Our study shows that MDCT of the coronary arteries is a reliable and noninvasive technique, which can accurately locate the site of myocardial bridging, and measure its thickness, course, and length.
心肌桥是一种先天性疾病，其中心外膜动脉的一段在心肌内走行于壁内。本研究的目的是评估心肌桥的患病率以及64层冠状动脉计算机断层扫描血管造影术识别无症状成年人心肌桥的能力。
169例连续的无症状受试者接受了冠状动脉64排多层螺旋计算机断层扫描（MDCT）。两位经验丰富的CT放射科医生通过共识确定心肌桥厚度>1mm。我们检查了心肌桥的发生率，并评估了其长度、厚度和冠状动脉壁病变。
165例受试者中有28例（17%）发现心肌桥。21例受试者（75%）有1个心肌桥，7例受试者（25%）有2个心肌桥，共有35个心肌桥。21个心肌桥（60%）位于左前降支，8.5%位于对角支，2.8%位于回旋支动脉。心肌桥下的节段总是没有冠状动脉壁斑块，但在其近端的动脉节段有24例（68.6%）有显著的冠状动脉壁斑块。
我们发现无症状成年人中心肌桥的发生率为7%，这与文献中的一些病理学研究一致。我们的研究表明，冠状动脉MDCT是一种可靠的非侵入性技术，它可以准确地定位心肌桥的部位，并测量其厚度、走行和长度。
