Wong C K, Freedman S B, Bautovich G, Shibuya T, Kelly D T
Hallstrom Institute of Cardiology, University of Sydney, Royal Prince Alfred Hospital, Australia.
Eur Heart J. 1993 Apr;14(4):469-73. doi: 10.1093/eurheartj/14.4.469.
A semi-quantitative right coronary artery score (RCA score) was derived from the ratio of the number of the major left ventricular branches of the right coronary artery to the total of the right coronary and left circumflex arteries, to stratify the extent of perfusion in patients with right coronary artery dominance. Thirty-seven patients with one-vessel coronary disease involving a dominant right coronary artery proximal to the left ventricular branches were selected for study. Thallium scintigraphy was performed after right intracoronary injection in 11 patients, and 26 patients underwent conventional stress thallium scintigraphy (24 exercise thallium and two dipyridamole thallium scintigraphy). Thallium scores of perfusion region size after right intracoronary thallium injection and perfusion defect size in stress thallium studies were quantitated from planar thallium images. Both the RCA score and the regional thallium scores spanned over a wide range. The RCA score (range 0.23-0.85) correlated best with the posterior (70 degrees left anterior oblique view) plus lateral segment (40 degrees left anterior oblique view) thallium score (r = 0.88 and 0.53 for intracoronary and stress thallium studies respectively). It also correlated with the summed thallium scores in the posterior, lateral, apical and inferior segments (r = 0.73 and 0.54 respectively) but not with thallium scores in the apex or inferior segment alone. The proposed RCA score quantitates the variable posterolateral perfusion territory of the right coronary artery, and could stratify the area of myocardium at risk from coronary stenosis in the majority of patients with right coronary dominance.
通过右冠状动脉主要左心室分支数量与右冠状动脉和左旋支动脉总数的比值得出半定量右冠状动脉评分（RCA评分），以对右冠状动脉优势型患者的灌注范围进行分层。选择37例单支冠状动脉疾病且右冠状动脉在左心室分支近端占优势的患者进行研究。11例患者在右冠状动脉内注射后进行铊闪烁扫描，26例患者接受传统的负荷铊闪烁扫描（24例运动铊闪烁扫描和2例双嘧达莫铊闪烁扫描）。从平面铊图像中对右冠状动脉内注射铊后灌注区域大小的铊评分和负荷铊研究中的灌注缺损大小进行定量。RCA评分和区域铊评分均涵盖较宽范围。RCA评分（范围0.23 - 0.85）与后侧壁（左前斜位70度视图）加侧壁节段（左前斜位40度视图）铊评分相关性最佳（冠状动脉内注射和负荷铊研究的r分别为0.88和0.53）。它还与后侧壁、侧壁、心尖和下壁节段的铊总分相关（分别为r = 0.73和0.54），但与单独的心尖或下壁节段铊评分无关。所提出的RCA评分可定量右冠状动脉可变的后外侧灌注区域，并可对大多数右冠状动脉优势型患者因冠状动脉狭窄而处于危险中的心肌区域进行分层。
