Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
Int J Cardiovasc Imaging. 2012 Feb;28(2):405-14. doi: 10.1007/s10554-011-9817-2. Epub 2011 Feb 24.
The aim of our study was to evaluate the atherosclerotic pattern of patients with coronary myocardial bridging (MB) by means of CT Coronary Angiography (CT-CA). 254 consecutive patients (166 male, mean age 58.6 ± 10.3) who underwent 64-slice CT-CA according to current clinical indications were reviewed for the presence of MB and concomitant segmental atherosclerotic pattern. Coronary plaques were assessed in all patients enrolled. 73 patients (29%) presented single (90%) or multiple (10%) MB, frequently (93%) localized in the mid-distal left anterior descending artery. The MB segment was always free of atherosclerosis. Segments proximal to the MB presented: no atherosclerotic disease (n = 37), positive remodeling (n = 23), <50% (n = 14), or >50% stenoses (n = 7). Distal segments presented a different atherosclerosis pattern (P < 0.0001): absence of disease (n = 73), no significant lesions (n = 8). No significant differences were found between segments proximal to MB and proximal coronary segments apart from left main trunk. Pattern of atherosclerotic lesions located in segments 6 and 7 significantly differs between patients with MB and patients without MB (P < 0.05). CT-CA is a reliable method to non-invasively demonstrate MB and related atherosclerotic pattern. CT-CA provides new insight regarding atherosclerosis distribution in segments close to MB.
我们的研究目的是通过 CT 冠状动脉造影（CT-CA）评估冠状动脉心肌桥（MB）患者的动脉粥样硬化模式。回顾了 254 例连续患者（166 例男性，平均年龄 58.6±10.3），他们根据当前的临床适应症接受了 64 层 CT-CA，以评估 MB 的存在和伴发的节段性动脉粥样硬化模式。所有入组患者均评估了冠状动脉斑块。73 例（29%）患者存在单发（90%）或多发（10%）MB，常位于左前降支中远段（93%）。MB 节段始终无动脉粥样硬化。MB 近端节段表现为：无动脉粥样硬化疾病（n=37）、正性重构（n=23）、<50%狭窄（n=14）或>50%狭窄（n=7）。远段节段表现出不同的动脉粥样硬化模式（P<0.0001）：无疾病（n=73）、无显著病变（n=8）。MB 近端节段与除左主干外的其他近端冠状动脉节段之间无显著差异。MB 患者与非 MB 患者的节段 6 和 7 中动脉粥样硬化病变的模式存在显著差异（P<0.05）。CT-CA 是一种可靠的方法，可以无创性地显示 MB 和相关的动脉粥样硬化模式。CT-CA 提供了关于 MB 附近节段动脉粥样硬化分布的新见解。
