Javadrashid R, Tarzamni M K, Aslanabadi N, Ghaffari M, Salehi A, Sorteji K
Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Folia Morphol (Warsz). 2009 Nov;68(4):201-6.
Advances in 64-row multidetector computed tomography have provided noninvasive imaging of coronary arteries. The aim of this study was to evaluate the prevalence of coronary artery anomalies in Iranian symptomatic patients and to determine the presence of anomalies resulting in myocardial ischaemia without atherosclerotic plaque. This study was carried out in Tabriz University of medical sciences on 534 patients with suggestive symptoms for coronary artery diseases. Original slices were reconstructed from data achieved by using a ECG-gated multidetector computed tomography scanner, and reconstructed 3-dimentional images of the heart were reviewed. Congenital angiography was performed in 36.3% of patients. The prevalence of myocardial bridging in symptomatic patients was 6.0% by multidetector computed tomography while conventional angiography could detect 20% of them. The most prevalent site was the middle portion of the left anterior descending artery. Anomalous origin or course of coronary arteries and AV fistula was detected by multidetector computed tomography coronary angiography in 2.6% of cases while conventional angiography could detect 44.4% of these anomalies. The prevalence of atherosclerotic plaques in patients with myocardial bridging was 53.1%. In 46.9% of these patients, myocardial bridging was held responsible for signs and symptoms of myocardial ischaemia as no atherosclerotic plaque was evident. This rate was 64.3% in symptomatic patients with other anomalies in origin or course of coronary arteries. This study gives the prevalence of coronary artery anomalies and myocardial bridging in the Iranian population. The results suggest multidetector computed tomography coronary angiography as the preferred utility for diagnosing such anomalies.
64排多层螺旋CT的进展为冠状动脉提供了无创成像。本研究的目的是评估伊朗有症状患者冠状动脉异常的患病率，并确定无动脉粥样硬化斑块导致心肌缺血的异常情况。本研究在大不里士医科大学对534例有冠状动脉疾病提示症状的患者进行。原始切片由使用心电图门控多层螺旋CT扫描仪获得的数据重建，对重建的心脏三维图像进行了评估。36.3%的患者进行了先天性血管造影。多层螺旋CT显示有症状患者心肌桥的患病率为6.0%，而传统血管造影可检测出其中的20%。最常见的部位是左前降支动脉中部。多层螺旋CT冠状动脉造影在2.6%的病例中检测到冠状动脉起源或走行异常及房室瘘，而传统血管造影可检测出这些异常的44.4%。心肌桥患者动脉粥样硬化斑块的患病率为53.1%。在这些患者中，46.9%的患者心肌桥被认为是心肌缺血体征和症状的原因，因为没有明显的动脉粥样硬化斑块。在冠状动脉起源或走行有其他异常的有症状患者中，这一比例为64.3%。本研究给出了伊朗人群冠状动脉异常和心肌桥的患病率。结果表明多层螺旋CT冠状动脉造影是诊断此类异常的首选方法。
