Shi Ke, Gao Hong-Ling, Yang Zhi-Gang, Zhang Qin, Liu Xi, Guo Ying-Kun
Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Department of Cardiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Int J Cardiol. 2017 Feb 1;228:80-85. doi: 10.1016/j.ijcard.2016.11.169. Epub 2016 Nov 9.
To evaluate the efficacy of dual-source computed tomography (DSCT) in assessing the morphological features, quantitative features, and associated coronary artery lesions among patients with coronary artery fistula (CAF) before surgery.
We enrolled 34 patients with CAF that were morphologically and quantitatively analyzed by DSCT and compared the analyses with surgical results (reference standard). The associated coronary artery lesions were also assessed.
By DSCT, we identified 15 patients (44.1%) with left-sided CAF, 9 (26.5%) with right-sided CAF, and 10 (29.4%) with bilateral CAF; the left anterior descending coronary artery (50.0%) was most frequently involved. Drainage was most commonly in the main pulmonary artery (41.2%), and those with right-sided CAF had larger feeding coronary arteries and drainage sites than those with left-sided or bilateral CAF (p<0.05). All the morphological features presented by DSCT were confirmed at surgery. In the quantitative analysis of CAF, DSCT was as accurate as surgery (r=0.95-0.98, p<0.001), and it was able to evaluate associated lesions accurately, including arteriosclerotic plaques, coronary artery aneurysms, and myocardial bridges. The evaluation could be completed in a single scan, without requiring an increased radiation dose (mean ED=2.27±1.92mSv).
DSCT is an alternative noninvasive imaging method that enables accurate assessment of morphological features, quantitative features, and associated coronary artery lesions in patients with CAF. It can be used to provide comprehensive information for determining surgical strategies.
评估双源计算机断层扫描（DSCT）在术前评估冠状动脉瘘（CAF）患者的形态学特征、定量特征及相关冠状动脉病变中的疗效。
我们纳入了34例经DSCT进行形态学和定量分析的CAF患者，并将分析结果与手术结果（参考标准）进行比较。同时还评估了相关的冠状动脉病变。
通过DSCT，我们识别出15例（44.1%）左侧CAF患者、9例（26.5%）右侧CAF患者和10例（29.4%）双侧CAF患者；冠状动脉左前降支最常受累（50.0%）。引流最常见于主肺动脉（41.2%），右侧CAF患者的供血冠状动脉和引流部位比左侧或双侧CAF患者更大（p<0.05）。DSCT呈现的所有形态学特征在手术中均得到证实。在CAF的定量分析中，DSCT与手术一样准确（r=0.95 - 0.98，p<0.001），并且能够准确评估相关病变，包括动脉粥样硬化斑块、冠状动脉瘤和心肌桥。评估可在一次扫描中完成，无需增加辐射剂量（平均有效剂量=2.27±1.92mSv）。
DSCT是一种可供选择的非侵入性成像方法，能够准确评估CAF患者的形态学特征、定量特征及相关冠状动脉病变。它可用于为确定手术策略提供全面信息。
