ISSN 1004-4140
CN 11-3017/P

冠状动脉CTA在冠状动脉-肺动脉瘘中诊断价值的回顾性研究

Coronary Artery CT Angiography in Coronary-pulmonary Fistula:A Retrospective Study

  • 摘要: 目的:探讨冠状动脉CTA在冠状动脉-肺动脉瘘(CPF)诊断中的临床价值。材料和方法:回顾性分析2011年10月至2016年10月于我院行冠脉CTA确诊的CPF共13例,其中男8例,女5例,年龄范围53~71岁,平均年龄62岁,心率61~73次/min,所有患者均行回顾性心电门控冠状动脉CTA成像,所得图像采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)和曲面重组(CPR),观察CPF。结果:13例确诊为CPF的患者中,单侧冠状动脉供血7例,双侧冠状动脉同时供血6例,其中左前降支近段为主要供血动脉共8例(61.5%)。所有CPF均于心表面观察到不规则高密度迂曲扩张血管团,表现为"团簇状"改变,13例可见畸形血管团,7例肺动脉可见"喷射征",6例可见肺动脉内"烟雾征"。5例供血动脉可见动脉瘤形成。9例供血冠状动脉呈轻-中度狭窄,且均位于畸形血管开口近端。结论:冠脉CTA可准确检出CPF,迂曲扩张的团"簇状"血管团和冠状动脉-肺动脉瘘口"喷射征"是CPF的典型征象。

     

    Abstract: Objective: To investigate the clinical value of coronary CT angiography in detection of coronary-pulmonary artery fistula (CPF). Materials and Methods: Thirteen patients with the diagnosis of CPF were enrolled in this study. All the patients were performed with retrospective ECG-gated coronary CTA, including 8 males and 5 females (age range, 53-71 years, mean age, 62 years old). The heart rate ranged from 61 to 73 bpm. All the raw data were reconstructed with VR, MIP, MPR and CPR, and all the CPF were retrospectively analyzed. Results: In all 13 patients with CPF, 7 were fed with unilateral coronary artery, while the number of bilateral coronary blood supply was 6. The main feeding artery was proximal left anterior descending in 8 patients (61.5%). All CPF demonstrated dilated vascular coat presenting as "clustering shape" on the surface of the heart. All 13 patients demonstrated dilated feeding artery, 7 with "jet sign" in pulmonary artery fistula, while "smoking sign" were demonstrated in 6 patients. 5 aneurysms were detected in the feeding artery, and 9 feeding artery were found stenosis in the proximal point. Conclusion: Coronary CT angiography demonstrates capability in the diagnosis of CPF with characteristic imaging features of"clustering vessel coat" and "jet" sign.

     

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