目的　探讨电子束CT(EBCT)在先天性冠状动脉异常诊断中的临床价值。方法　对EBCT诊断为先天性冠状动脉异常 ,并有心血管造影和 (或 )手术结果的 2 0例患者进行回顾性分析。其中 16例行心血管造影。男 13例 ,女 7例 ,年龄 5个月至 70岁 ,平均 15 5岁。除 1例行连续容积扫描外 ,19例采用单层增强扫描 ,其中 1例同时行单层平扫和电影序列 ,1例加行电影序列。结果　 2 0例中 ,EBCT提示 19例先天性冠状动脉异常征象并做出正确诊断 ,包括 5例起源分布异常、6例单支冠状动脉畸形和 8例冠状动脉瘘 ;造影 16例确诊 15例。两种诊断方法诊断结果无显著性差异 (经 χ2 检验 ,χ2 =0 32 ,P >0 0 5 )。结论　EBCT是一种较为理想的无创性诊断冠状动脉先天性异常的方法 Objective To investigate the clinical value of electron beam computed tomography (EBCT) in the diagnosis of congenital coronary artery abnormalities. Methods Twenty patients with congenital coronary artery abnormalities diagnosed by EBCT who underwent angiography and / or surgery were retrospectively analyzed. Sixteen patients underwent cardiovascular angiography. 13 males and 7 females, aged 5 months to 70 years, an average of 15 5 years old. In addition to a routine continuous volume scan, 19 cases of single-slice enhanced scanning, including 1 case of simultaneous plain scan and movie sequences, one case of additional movie sequence. Results Twenty-nine cases of congenital abnormalities of coronary arteries were diagnosed by EBCT in twenty cases, including 5 cases of abnormal distribution of origin, 6 cases of single coronary artery malformations and 8 cases of coronary fistulas. Fifteen cases were diagnosed by contrast-enhanced angiography in 16 cases. The diagnostic results of the two diagnostic methods showed no significant difference (χ2 test, χ2 = 0 32, P> 0 0 5). Conclusion EBCT is an ideal noninvasive method to diagnose congenital anomalies of coronary arteries