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先天性冠状动脉异常:64 层多排 CT 的诊断。

Congenital anomalies of coronary arteries: Diagnosis with 64 slice multidetector CT.

机构信息

Consultant Radiologists, Advanced Radiology Clinic, Behind Hamdard University Hospital, Off M.A. Jinnah Road, Karachi, Pakistan.

出版信息

Eur J Radiol. 2012 Aug;81(8):1790-7. doi: 10.1016/j.ejrad.2011.05.034. Epub 2011 Jul 12.

Abstract

OBJECTIVE

Congenital coronary artery anomalies are generally incidental, uncommon and asymptomatic. Some can cause severe potentially life threatening symptoms. The common mode of studying the coronary arteries is Conventional Coronary Angiogram. ECG-gated-multidetector CT is a non invasive modality. The objective of our study was to identify rare congenital coronary artery anomalies and discuss their clinical significance.

MATERIAL AND METHODS

A total number of 900 MDCT coronary angiograms were carried out at our institution between the period of April 2006 and October 2010. Patients with coronary artery anomaly constituted the subject of study.

RESULTS

The incidence of anomalous anatomical origin and course of the coronary arteries in our study was 1.55%. Hemodynamical significance was seen in five patients. 3 cases of single coronary artery originating from right coronary sinus were seen. 1 case of anomalous left coronary artery arising from main pulmonary artery was seen. 4 cases of anomalous RCA arising from left aortic cusp, 6 cases of absent LMCA with separate origin of LAD and LCX were seen.

CONCLUSION

Multidetector row CT is a noninvasive modality in cardiac imaging. It provides superior resolution of coronary tree and its variant. No projectional vascular overlap is seen. Various postprocessing techniques outclass catheter angiography imaging. Definition of ostia and proximal course of the coronary arteries by Multidetector CT is better than catheter angiography.

摘要

目的

先天性冠状动脉异常通常是偶然的、罕见的且无症状的。有些可能会导致严重的潜在威胁生命的症状。研究冠状动脉的常见方法是常规冠状动脉造影。心电图门控多排 CT 是一种非侵入性的方法。我们的研究目的是确定罕见的先天性冠状动脉异常,并讨论其临床意义。

材料和方法

在我们机构,于 2006 年 4 月至 2010 年 10 月期间共进行了 900 例 MDCT 冠状动脉造影。冠状动脉异常患者构成了本研究的对象。

结果

在我们的研究中,冠状动脉解剖起源和走行异常的发生率为 1.55%。5 例患者存在血流动力学意义。3 例单支冠状动脉起源于右冠状动脉窦。1 例左冠状动脉异常起源于主肺动脉。4 例右冠状动脉异常起源于左主动脉瓣,6 例左主干缺失,左前降支和左回旋支分别起源。

结论

多排 CT 是心脏成像的一种非侵入性方法。它提供了冠状动脉及其分支的更高分辨率。不存在投影血管重叠。各种后处理技术优于导管血管造影成像。多排 CT 对冠状动脉口和近端的定义优于导管血管造影。

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