【摘要】：目的:探討伴心律失常癥狀心肌橋患者的冠狀動脈計算機(jī)斷層攝影術(shù)(CTA)影像學(xué)特征。方法:收集表現(xiàn)有心律失常的心肌橋患者(有心律失常組)31例的臨床及影像學(xué)資料,包括病歷記錄、心電圖、心肌酶、超聲心動圖和CTA資料。重點(diǎn)研究其CTA影像學(xué)表現(xiàn)。另選取30例無心律失常單純心肌橋患者(無心律失常組)作為對照。結(jié)果:有心律失常組31例患者均只表現(xiàn)為單純心肌橋,排除了冠心病、瓣膜結(jié)構(gòu)性心臟病及其它系統(tǒng)性疾病的病因。31例患者中心室顫動2例,心房顫動1例,室上性心動過速5例,室性心動過速23例。31例患者中17例為深埋型,14例為淺表型。與無心律失常組比較,有心律失常組回顧性心電門控心肌收縮末期直徑和心肌舒張末期直徑、CTA上其壁冠狀動脈橫斷面管腔變窄率差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:有心律失常心肌橋患者CTA表現(xiàn)無明顯特點(diǎn),CTA上顯示的心肌橋病理解剖特點(diǎn)只是可用來解釋部分心肌顯著缺血引起的臨床癥狀,不能完全解釋心肌橋患者的心律失常。
[Abstract]:Objective: to investigate the (CTA) imaging features of coronary artery computed tomography (CT) in patients with cardiac bridge with arrhythmia symptoms. Methods: the clinical and imaging data of 31 patients with cardiac bridge with arrhythmia were collected, including medical records, electrocardiogram, myocardial enzymes, echocardiography and CTA data. The CTA imaging findings were studied emphatically. Another 30 patients with no arrhythmia and simple myocardial bridge (no arrhythmia group) were selected as control group. Results: all the 31 patients with arrhythmia showed myocardial bridge, excluding the causes of coronary heart disease, valvular structural heart disease and other systemic diseases, including 2 cases of ventricular fibrillation and 1 case of atrial fibrillation. There were 5 cases of supraventricular tachycardia and 23 cases of ventricular tachycardia. Compared with the non-arrhythmic group, there was no significant difference in the diameter of end-systolic and end-diastolic myocardium and the narrowing rate of cross-sectional lumen of coronary artery on CTA in the patients with arrhythmia (P0.05). Conclusion: there is no obvious characteristic of CTA in patients with arrhythmia myocardial bridge. The pathological and anatomical features of myocardial bridge displayed on CTA can only be used to explain the clinical symptoms caused by significant myocardial ischemia, but can not completely explain the arrhythmia in patients with myocardial bridge.
【作者單位】： 上海市浦東新區(qū)周浦醫(yī)院放射科;上海市浦東新區(qū)周浦醫(yī)院心內(nèi)科;
【基金】：2015年度上海市浦東新區(qū)領(lǐng)先人才培養(yǎng)計劃項目資助項目(PRWI 2015-01)
【分類號】：R541.1;R816.2

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