Zhao Xin-Bin, Fu Yu, Dong Xiao-Bo, Qi Zhi
Department of CT, the Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China.
Department of Nuclear Medicine, Kailuan General Hospital, Tangshan,Hebei 063000,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2016 Dec 20;38(6):654-659. doi: 10.3881/j.issn.1000-503X.2016.06.006.
Objective To explore the impact of myocardial bridge-mural coronary artery (MB-MCA) on myocardial blood supply. Methods The imaging data of 74 patients with the isolate MB in the left anterior descending artery undergoing 256-slice CT coronary angiography and myocardial perfusion imaging (MPI) were retrospectively analyzed. The subjects were divided into incomplete and complete MB types. The length of MB and the systolic stenosis degree of MCA were measured.The type and length of MB and the systolic stenosis degree of MCA (according to Noble grade) were compared between the normal and abnormal MPI groups. The clinical characteristics including age, gender, body mass index, hypertension, dyslipidemia, diabetes mellitus, and smoking history were also reviewed. Results There were 38 incomplete MB cases and 13 complete MB cases in the normal MPI group,and 5 and 18 in the abnormal MPI group (χ=18.134,P=0.000). The MB length in the normal and abnormal MPI group were (14.7±3.7) mm and (15.5±4.5) mm (t=0.804,P=0.424). However, the systolic stenosis degree of MCA showed significant difference (χ=17.839,P=0.000). The clinical characteristics were not significantly differentt between the normal and abnormal MPI groups (P>0.05). Conclusions The MB type and the systolic stenosis degree of MCA can affect myocardial perfusion.Patients with complete MB and the moderate-to-severe systolic stenosis degree of MCA are more susceptible to myocardial ischemia. However, the MB length is not correlated with myocardial ischemia.
目的 探讨心肌桥-壁冠状动脉（MB-MCA）对心肌血供的影响。方法 回顾性分析74例孤立性左前降支心肌桥患者行256层CT冠状动脉造影及心肌灌注成像（MPI）的影像资料。将研究对象分为不完全型和完全型心肌桥。测量心肌桥长度及壁冠状动脉收缩期狭窄程度。比较正常MPI组与异常MPI组心肌桥类型、长度及壁冠状动脉收缩期狭窄程度（按Noble分级）。同时回顾患者年龄、性别、体重指数、高血压、血脂异常、糖尿病及吸烟史等临床特征。结果 正常MPI组中不完全型心肌桥38例，完全型心肌桥13例；异常MPI组中不完全型心肌桥5例，完全型心肌桥18例（χ=18.134，P=0.000）。正常MPI组与异常MPI组心肌桥长度分别为（14.7±3.7）mm和（15.5±4.5）mm（t=0.804，P=0.424）。但壁冠状动脉收缩期狭窄程度差异有统计学意义（χ=17.839，P=0.000）。正常MPI组与异常MPI组临床特征差异无统计学意义（P>0.05）。结论 心肌桥类型及壁冠状动脉收缩期狭窄程度可影响心肌灌注。完全型心肌桥且壁冠状动脉收缩期中度至重度狭窄的患者更易发生心肌缺血。然而，心肌桥长度与心肌缺血无关。
