[1]周玉祥,蓝博文,黄春榆,等.64排螺旋CT冠状动脉血管成像诊断冠状动脉-肺动脉瘘的应用价值[J].国际放射医学核医学杂志,2016,40(1):26-30.[doi:10.3760/cma.j.issn.1673-4114.2016.01.006]
　Zhou Yuxiang,Lan Bowen,Huang Chunyu,et al.Clinical value of coronary artery-pulmonary artery fistula revealed by 64-slice spiral CT coronary angiography[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(1):26-30.[doi:10.3760/cma.j.issn.1673-4114.2016.01.006]
点击复制

64排螺旋CT冠状动脉血管成像诊断冠状动脉-肺动脉瘘的应用价值(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第1期
页码:
26-30
栏目:
出版日期:
2016-01-25

文章信息/Info

Title:
Clinical value of coronary artery-pulmonary artery fistula revealed by 64-slice spiral CT coronary angiography
作者:
周玉祥;  蓝博文;  黄春榆;  饶红萍;  李丽红;  代海洋
516001, 惠州市中心人民医院放射科
Author(s):
Zhou Yuxiang;  Lan Bowen;  Huang Chunyu;  Rao Hongping;  Li Lihong;  Dai Haiyang
Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, China
关键词:
冠状动脉疾病; 肺动脉; 体层摄影术; X线计算机; 动脉-动脉漏
Keywords:
Coronary disease; Pulmonary artery; Tomography; X-ray computed; Arterio-arterial fistula
DOI:
10.3760/cma.j.issn.1673-4114.2016.01.006
摘要:
目的 评价64排螺旋CT三维重组技术诊断冠状动脉-肺动脉瘘(CPF)的应用价值。方法 回顾性分析20例行64排螺旋CT冠状动脉血管成像的CPF患者的资料,其图像行容积再现、多平面重组、曲面重组、最大密度投影,分析CPF的检出率、异常血管的CT特征及多排螺旋CT的诊断意义。结果 CPF血管起源:左冠状动脉分支或左圆锥支11例,左冠状动脉分支及右圆锥支(或左右圆锥支)7例,右圆锥支1例,双侧冠状动脉多分支1例。异常血管形态:迂曲扩张血管网19例,单纯扩张血管1例,匍匐于肺动脉壁20例;合并囊状动脉瘤5例,梭形动脉瘤1例。肺动脉瘘口的位置:主肺动脉左侧壁14例,左前壁1例,前壁2例,左侧壁和前壁1例,左前壁和右侧壁1例,未见明确瘘口1例。瘘口的CT特征:开窗征17例,射血征8例,烟雾征3例,飘带征1例,等密度征10例。结论 多排螺旋CT重组技术可清晰显示CPF的异常血管及瘘口特征,为临床诊治提供重要信息,可作为诊断的首选方法。
Abstract:
Objective To evaluate the value of the three dimensional multi-slice spiral CT in the diagnosis of coronary artery-pulmonary artery fistula(CPF).Methods Retrospectively analyzed the multi-slice spiral CT images of 20 CPF patients diagnosed by coronary CT angiography.All of the cases were used in volume rendering,multiplanar reformation,curved planar reformation,and maximum intensity projection.Moreover,the incidence,the features of the abnormal vessels revealed by multi-slice spiral CT,and the diagnostic significance of CPF were retrospectively summarized.Results The origin of CPF vessels was the branch of left coronary artery or left conus branch in 11 cases,the branch of left coronary artery and right conus branch in 7 cases,the right conus branch in 1 case,and the multi-branch of left and right coronary artery in 1 case.The abnormal vessels demonstrated a tortuous dilatation in 19 cases and a tubular dilatation in 1 case.CPF extended into the pulmonary artery wall in 20 cases;companied with aneurysm in 5 cases and fusiform aneurysm in 1 case.Moreover,the pulmonary artery fistulas were located in the left wall of the main pulmonary artery in 14 cases,in the left anterior wall in 1 case,in the anterior wall in 2 cases,in the left and anterior wall in 1 case,and in the anterior and right wall in 1 case;pulmonary artery fistulas were absent in 1 case.The CT features of the pulmonary artery fistula concluded a window sign in 17 cases,an ejection sign in 8 cases,a smoke sign in 3 cases,a streamer sign in 1 case,and an isodensity sign in 10 cases.Conclusion The 3D-MSCT can clearly visualize abnormal vessels and fistula.Thus,this method can be considered as the primary choice in CPF diagnosis and treatment.

参考文献/References:

[1] 孔淑红,岳学旺,孔生.冠状动脉瘘的CT诊断价值[J].中国临床医学影像杂志,2015,26(2):134-136.Kong SH,Yue XW,Kong S.Value of CT in the diagnosis of coronary artery fistula[J].J Chin Clin Med Imaging,2015,26(2):134-136.
[2] 周长圣,张龙江,王怡宁,等.双源CT冠状动脉成像冠状动脉瘘的检出率及分型诊断[J].中华医学杂志,2012,92(47):3336-3340.DOI:10.3760/cma.j.issn.0376-2491.2012.47.008.Zhou CS,Zhang LJ,Wang YN,et al.Incidence and classification diagnosis of coronary artery fistula at dual-source CT coronary angiography[J].Natl Med J Chin,2012,92(47):3336-3340.
[3] Yun H,Zeng MS,Yang S,et al.Congenital coronary artery fistulas:dual-source CT findings from consecutive 6624 patients with suspected or confirmed coronary artery disease[J].Chin Med J,2011,124(24):4172-4177.
[4] Abdelmoneim SS,Mookadam F,Moustafa S,et al.Coronary artery fistula:single-center experience spanning 17 years[J].J Interv Cardiol,2007,20(4):265-274.DOI:10.1111/j.1540-8183.2007.00267.x.
[5] 李景雷,黄美萍,崔燕海,等.冠状动脉-肺动脉瘘多排螺旋CT征象分析[J].暨南大学学报:自然科学与医学版,2013,34(2):221-225.DOI:10.3969/j.issn.1000-9965.2013.02.021.Li JL,Huang MP,Cui YH,et al.The analysis of CT features of coronary artery-pulmonary artery fistula[J].Jinan Univ Natur Sci & Med,2013,34(2):221-225.
[6] 曹志坚,许茂盛,陈智能,等.冠状动脉瘤样扩张征象在CT诊断冠状动脉瘘中的意义[J].医学影像学杂志,2015,25(4):625-627.Cao ZJ,Xu MS,Chen ZN,et al.The significance of aneurismal dilatation in diagnosing coronary artery fistula by CT angiography[J].J Med Imaging,2015,25(4):625-627.
[7] 杨姗,曾蒙苏,恽虹,等.冠状动脉瘘的CT血管成像表现[J].中华心血管病杂志,2011,39(8):739-742.DOI:10.3760/cma.j.issn.0253-3758.2011.08.012.Yang S,Zeng MS,Yun H,et al.Imaging feature of computed tomography angiography in patients with coronary artery fistulas[J].Chin J Cardiol,2011,39(8):739-742.
[8] Kim SY,Seo JB,Do KH,et al.Coronary artery anomalies:Classification and ECG-gated multi-detector row CT findings with angiographic correlation[J].Radiographics,2006,26(2):317-334.DOI:http://dx.doi.org/10.1148/rg.262055068.
[9] Woo JJ,Koh YY,Ha SI,et al.Non-invasive recognition of generalized coronary arteriosystemic fistulae by contrast echocardiography and multidetector CT[J].Int J Cardiovasc Imaging,2011,27(5):749-753.DOI:10.1007/s10554-011-9866-6.
[10] 于喜红,杨瑞,刘继伟.双源CT结合超声对小儿先天性冠状动脉瘘的诊断价值[J].中国医学计算机成像杂志,2015,21(1):38-42.Yu XH,Yang R,Liu JW.Value of dual-source computed tomography coronary angiography and echocardiography in diagnosis of congenital coronary artery fistula in children[J].Chin Comput Med Imaging,2015,21(1):38-42.

相似文献/References:

[1]汪娇,李剑明.18F-FDG PET心肌代谢显像在心肌存活诊断中的应用进展[J].国际放射医学核医学杂志,2015,39(3):252.[doi:10.3760/cma.j.issn.1673-4114.2015.03.014]
　Wang Jiao,Li Jianming.Development of 18F-FDG PET myocardial metabolic imaging in the diagnosis of myocardial survival[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(1):252.[doi:10.3760/cma.j.issn.1673-4114.2015.03.014]
[2]陈越,李剑明.影像融合技术在冠心病中的临床应用进展[J].国际放射医学核医学杂志,2014,38(1):37.[doi:10.3760/cma.j.issn 1673-4114.2014.01.008]
　Chen Yue,Li Jianming.Advances on the clinical applications of the image fusion techniques in coronary heart disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(1):37.[doi:10.3760/cma.j.issn 1673-4114.2014.01.008]
[3]张国建,王雪梅,刘艳阳.PET-CT在冠心病诊断中的临床应用及新进展[J].国际放射医学核医学杂志,2010,34(5):274.[doi:10.3760/cma.j.issn.1673-4114.2010.05.005]
　ZHA NG Guo-jian,WANG Xue-mei,LIU Yan-yang.New progress and clinical application of PET-CT in coronary artery disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(1):274.[doi:10.3760/cma.j.issn.1673-4114.2010.05.005]
[4]孙启和,孙彬,杨永青.冠心病患者血清细胞因子和超敏C-反应蛋白水平测定的临床意义[J].国际放射医学核医学杂志,2010,34(5):291.[doi:10.3760/cma.j.issn.1673-4114.2010.05.010]
　SUN Qi-he,SUN Bin,YANG Yong-qing.Clinical application of changes of serum cytokines and hypersensitive C-reactive protein in patients with coronary heart disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(1):291.[doi:10.3760/cma.j.issn.1673-4114.2010.05.010]
[5]邵晓梁,王跃涛.心肌灌注显像与冠状动脉钙化积分对冠心病风险评估的研究现状及相互关系[J].国际放射医学核医学杂志,2011,35(2):99.[doi:10.3760/cma.j.issn.1673-4114.2011.02.008]
　SHA Xiao-liang,WANG Yue-tao.The progress of interrelationship between myocardial perfusion imaging and coronary artery calcium score in cardiac risk assessment[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(1):99.[doi:10.3760/cma.j.issn.1673-4114.2011.02.008]
[6]栾兆生,周雯,唐为国,等.99Tcm标记化合物显像检测冠心病的优化方案探讨[J].国际放射医学核医学杂志,2010,34(1):42.[doi:10.3760/cma.j.issn.1673-4114.2010.01.011]
　LUAN Zhao-sheng,ZHOU Wen,TANG Wei-guo,et al.The optimal program of 99Tcm labeled radionuclide imaging in diagnosing coronary disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(1):42.[doi:10.3760/cma.j.issn.1673-4114.2010.01.011]
[7]杨波,刘长春,张勇,等.99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价[J].国际放射医学核医学杂志,2009,33(1):37.[doi:10.3760/cma.j.issn.1673-4114.2009.01.037]
　YANG Bo,LIU Chang-chun,ZHANG Yong,et al.Evaluation of the outcomes of 99Tcm-MIBI stress-rest perfusion imaging in coronary heart disease with percutaneous transluminal coronary angioplasty[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(1):37.[doi:10.3760/cma.j.issn.1673-4114.2009.01.037]
[8]张晓英,廖端芳.氡及其子体辐射诱发的非癌变效应[J].国际放射医学核医学杂志,2009,33(1):47.[doi:10.3760/cma.j.issn.1673-4114.2009.01.047]
　ZHANG Xiao-ying,LIAO Duan-fang.Radon and its products radiation-induced non-cancerous effect[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(1):47.[doi:10.3760/cma.j.issn.1673-4114.2009.01.047]
[9]程艳,李思进,李险峰,等.99Tcm-NOET门控心肌灌注SPECT评价冠心病的价值[J].国际放射医学核医学杂志,2009,33(5):257.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.001]
　CHENG Yah,LI Si-jin,LI Xian-feng,et al.Value of 99Tcm-NOET gated myocardial perfusion on patients with coronary heart disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(1):257.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.001]
[10]程旭,李殿富,徐兆强,等.冠心病影像学检查与辐射剂量[J].国际放射医学核医学杂志,2009,33(5):307.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.017]
　CHENG Xu,LI Dian-fu,XU Zhao-qiang,et al.Radiation dose of cardiac diagnostic imaging in patients with coronary artery disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(1):307.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.017]

备注/Memo

备注/Memo:
收稿日期:2015-08-31;改回日期:。
基金项目:惠州市科技计划项目(2014Y039)
通讯作者:周玉祥
更新日期/Last Update: 1900-01-01