摘要
目的分析先天性冠状动脉瘘(CAF)CT血管成像(CCTA)特征,探讨其发病机理。方法回顾性分析47例病人CT资料,男性21例,女性26例,年龄4个月至72岁。行容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)和曲面重组(CPR)成像,同期行超声心动图成像。冠状动脉造影6例,手术治疗26例。结果右冠状动脉瘘16例,其中瘘入肺动脉6例,右心房4例,右心室5例,左心室1例。左冠状动脉瘘25例,其中瘘入肺动脉12例,右心房4例,右心室5例,左心房2例,左心室2例。左右冠状动脉同时瘘入肺动脉6例。18例呈囊状、串珠状改变,5例呈巨大瘤样扩张。24例冠状动脉无明显扩张,仅表现血管迂曲。47例中,20例超声心动图表现为血管扩张、迂曲,血流信号异常。6例造影结果以及21例手术结果与CCTA相符合。结论 MSCT清楚显示CAF的起源、行程、引流部位及并发动脉瘤以及瘤内血栓,准确诊断CAF。其形成机理包括:心肌窦状隙先天发育不良,冠状动脉与心腔持续交通以及胚胎期冠状动脉与肺动脉交通支血管退化不完全,在压力刺激及容量刺激下,导致冠状动脉与心腔或与肺动脉持续交通,逐渐形成CAF。
Objective To analyze the characteristics of coronary artery fistula （CAF） with coronary computed tomography angiography （CCTA）, and to explore its mechanism. Methods All of 47 cases （21 men, 26 women; age range from 4 months-72 years） accepted CCTA, all image were performed volume render （VR）, maximum intensity projection （MIP）, multiplanar reconstruction （MPR） and curved planar reconstruction （CPR）. In the same period, all cases were examined with echocardiogram, of 6 cases with coronary angiography, and 21 cases were operated. Results The coronary arteries involved were distorted and dilated, in which 18 cases were displayed as cystic or beadlike, 5 cases as gigantic aneurysm, and 18 cases drained into the Pulmonary artery, 8 cases into the right atrium, 10 cases into the right ventricle, 2 cases into the left atrium, 3 cases into the left ventricle, and 6 cases manifested two branches of coronary artery malformation, which drained into the pulmonary artery. Of 20 cases were diagnosed with echocardiogram, and 6 cases were proved by angiography, 21 cases were proved by operation. Conclusion The characteristics of CAF includes distorted, dilated or crowded coronary, which bridges between coronary artery and cardiac chamber or pulmonary artery. The CCTA is an ideal noninvasive technique relatively. The mechanism may include not only the congenital heteroplasia of the myocardial sinuses, but also, in embryonic period, the incomplete degeneration of some vessels, which keeps opening between the coronary artery and the pulmonary artery, CAF could be caused by pressure stimulation and capacity stimulation, gradually.
出处
《中国CT和MRI杂志》
2010年第3期1-4,共4页
Chinese Journal of CT and MRI
关键词
冠状动脉瘘
断层
X线计算机
畸形
Coronary artery fistula
Tomography
X-ray computed
malformation
