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一项在一家三级医疗军队医院使用64层MDCT对冠状动脉变异和异常情况进行的研究。

A study of coronary artery variants and anomalies observed at a tertiary care armed forces hospital using 64-slice MDCT.

作者信息

Rao Akhilesh, Pimpalwar Yayati, Yadu Neha, Yadav R K

机构信息

Department of Radiodiagnosis & Imaging, Command Hospital (CC), Lucknow, India.

Department of Radiodiagnosis & Imaging, Command Hospital (CC), Lucknow, India.

出版信息

Indian Heart J. 2017 Jan-Feb;69(1):81-86. doi: 10.1016/j.ihj.2016.05.018. Epub 2016 Jun 10.

Abstract

BACKGROUND

Isolated coronary artery anomalies are usually clinically silent and mostly detected incidentally during angiography or autopsy. However, few of them may be implicated in cases of sudden cardiac death even in the absence of additional heart abnormalities. Prior knowledge of such variants and anomalies is necessary for planning various interventional procedures. Multiple detector computed tomography coronary angiography has proved a very useful non-invasive modality in this field given its superiority over conventional coronary angiography in providing detailed coronary artery anatomy.

METHODS

A retrospective review of the coronary CT angiography studies was carried out at our center between August 2014 and December 2015 with the purpose of describing the coronary artery variants and anomalies that we came across in our cohort.

RESULTS

In our cohort, about 77% (n=391) of the patients had a right dominant system while left dominant and co-dominant systems were seen in 12% (n=61) and 11% (n=56) respectively. Coronary CT angiography was successful in visualizing smaller branches, such as the conus artery (96.25%, n=489), the sinus node artery (83.07%, n=422), and the septal branches (95.27%, n=484). Coronary anomalies were observed in the 10.04% of our population (n=51). Eleven anomalies of origin and course were found.

CONCLUSION

Coronary CT angiography gives us a good understanding of the variations and anomalies of the anatomy of the coronary arteries. This can be of immense help to the clinician planning interventional procedures.

摘要

背景

孤立性冠状动脉异常通常在临床上无明显症状,大多在血管造影或尸检时偶然发现。然而,即使没有其他心脏异常,其中少数也可能与心源性猝死有关。了解这些变异和异常对于规划各种介入手术是必要的。多层螺旋CT冠状动脉造影已被证明是该领域一种非常有用的非侵入性检查方法,因为它在提供详细冠状动脉解剖结构方面优于传统冠状动脉造影。

方法

我们中心对2014年8月至2015年12月期间的冠状动脉CT血管造影研究进行了回顾性分析,目的是描述我们队列中遇到的冠状动脉变异和异常情况。

结果

在我们的队列中,约77%(n = 391)的患者为右优势型系统,而左优势型和共优势型系统分别见于12%(n = 61)和11%(n = 56)。冠状动脉CT血管造影成功显示了较小的分支,如圆锥动脉(96.25%,n = 489)、窦房结动脉(83.07%,n = 422)和间隔支(95.27%,n = 484)。在我们的研究人群中,10.04%(n = 51)观察到冠状动脉异常。发现了11种起源和走行异常。

结论

冠状动脉CT血管造影使我们能够很好地了解冠状动脉解剖结构的变异和异常。这对规划介入手术的临床医生有很大帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b234/5318984/3fde61d9c975/gr1.jpg

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