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目的探讨多层螺旋CT(MSCT)和冠状动脉造影(CAG)诊断心肌桥-壁冠状动脉(MB-MCA)的能力。方法对76例先后进行MSCT和CAG检查者,CT诊断和CAG诊断医师分别判断MB-MCA的有无,载MB-MCA血管形态特征。(1)采用双盲法MSCT和CAG分别独立阅片;(2)相互参照另1种检查结果后再次阅片。应用卡方统计分析方法,判断2种方法发现MB-MCA和判断血管迂曲有无差异。结果双盲法MSCT发现MB-MCA27例29处,CAG发现2例2处(χ2=24.55,P<0.05),MSCT发现22处(75.86%)载MB-MCA冠状动脉节段迂曲,CAG发现1处(χ2=28.82,P<0.05),2种方法差异有统计学意义。相互对照后再次评价,MSCT发现MB-MCA数量同前,CAG新发现7例7处,位置与MSCT一致,2种方法差异仍有统计学意义(χ2=10.52,P<0.05)。对22例MSCT诊断局部迂曲者,CAG也可证实,2种方法差异无统计学意义(χ2=0.33,P>0.05)。结论MSCT较CAG容易发现MB-MCA,CAG发现局部血管迂曲对MB-MCA有提示作用。
Objective To investigate the ability of multi-slice spiral CT (MSCT) and coronary angiography (CAG) in the diagnosis of myocardial bridge-wall coronary artery (MB-MCA). Methods Sixty-six MSCT and CAG examinations were performed. The CT diagnosis and CAG diagnosis were used to determine the MB-MCA vessel morphology. (1) using double-blind method MSCT and CAG were independent reading; (2) cross-reference to another kind of test results after reading again. Application of chi-square statistical analysis, to determine the two methods to find MB-MCA and determine the vascular tortuosity with or without differences. Results The double-blind MSCT found 29 MB-MCA in 27 cases, 2 cases in 2 cases (2 = 24.55, P <0.05) in CAG, 22 cases (75.86%) contained tortuous coronary arteries in MB- (Χ2 = 28.82, P <0.05), the difference between the two methods was statistically significant. After comparing with each other, MSCT found that the number of MB-MCA was the same as before. There were 7 newly discovered 7 cases in CAG, which were consistent with MSCT. The difference between the two methods was still statistically significant (χ2 = 10.52, P <0.05). Of the 22 patients with MSCT diagnosed locally, CAG also confirmed that there was no significant difference between the two methods (χ2 = 0.33, P> 0.05). Conclusion Compared with CAG, MSCT is more likely to find MB-MCA, CAG found that vascular tortuosity may be a hint to MB-MCA.