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目的探讨64层螺旋CT对冠状动脉瘘(CAF)的临床应用及诊断价值。资料与方法回顾性分析12例经手术或造影证实的CAF患者的CT资料。男8例,女4例,年龄2～74岁。所有图像均行容积再现(VR)、最大密度投影(M IP)、多平面重组(MPR)和曲面重组(CPR)成像。结果全组病例CAF的起源、行程、引流部位及并发异常均清晰显示,受累冠状动脉表现为走行迂曲、扩张,局部形成动脉瘤4例。单一瘘管11例,单纯起源于左冠状动脉5例,右冠状动脉4例;起源于左右双侧血管3例。多发瘘管1例。引流至右心系统9例、左心系统3例。结论64层螺旋CT可准确显示CAF的起源、行程、引流部位及并发异常,是一种较为理想的无创性诊断CAF的影像方法。
Objective To investigate the clinical application and diagnostic value of 64-slice spiral CT in coronary artery fistula (CAF). Materials and Methods Retrospective analysis of CT data of 12 CAF patients confirmed by surgery or angiography. 8 males and 4 females, aged 2 to 74 years old. All images were subjected to volume rendering (VR), maximum density projection (MPI), multiplanar reconstruction (MPR) and surface reconstruction (CPR) imaging. Results The origin, stroke, drainage site and concomitant abnormalities of CAF in all the cases were clearly demonstrated. The involved coronary arteries showed tortuosity and dilation, and 4 aneurysms formed locally. Single fistula in 11 cases, simple originated in 5 cases of left coronary artery, right coronary artery in 4 cases; originated in bilateral blood vessels in 3 cases. Multiple fistula cases. Drainage to the right heart 9 cases, left heart 3 cases. Conclusion 64-slice spiral CT can accurately show the origin, stroke, drainage sites and concomitant abnormalities of CAF. It is an ideal imaging method for non-invasive diagnosis of CAF.