| Part ?:The Value of Coronary CTA and DSA in the Diagnosis of Coronary DysplasiaObjective:To study the clinical value of coronary CTA and DSA in the diagnosis of coronary dysplasia.Materials and Methods:1154 patients underwent MSCT angiography in the First Affiliated Hospital of Soochow University from January 2016 to December 2016 were retrospectively analyzed to observe the incidence,pathological types and imaging findings of congenital development abnormality of coronary artery,so as to carry on the statistical analysis in contrast to DSA.Results:there were 272 patients with coronary dysplasia in 1154 patients,accounting for 23.57%.Among them,9 cases had the high orifice of the left coronary artery,8 cases had the high orifice of the right coronary artery,1 case had single coronary artery,and 1 case had the absence of the left main coronary artery.There were 2 cases of left anterior descending(LAD)-pulmonary artery fistula,1 case of anterior descending branch coronary aneurysm,1 case of right coronary artery fistula and left anterior descending artery fistula,2 cases of right coronary artery originating from left coronary sinus,4 cases of coronary artery dysplasia.Moreover,there were 244 cases of myocardial bridge.Among them,241 had single-vessel myocardial bridge,accounting for 98.77%,3 had two-vessel myocardial bridge,accounting for 1.23%.There was no significant difference in the type of coronary dysplasia of patients with different gender(p>0.05).144 patients had underwent CTA and DSA at the same time,the detection rate of coronary dysplasia by CTA was significantly higher than that by DSA,and the difference was of statistical significance(p<0.05).CTA was detected in 39 cases were detected by CTA(27.08%),9 cases by DSA(6.25%);The detection rate of myocardial bridge by CTA was significantly higher than that by DSA,the difference was statistically significant(p<0.05);there was no significant difference in other types of coronary dysplasia(p>0.05).Conclusion:CTA can accurately show the type,course,location and relationship with adjacent tissues of coronary dysplasia.It is more convenient and accurate by CTA than that by DSA in evaluating coronary dysplasia,which can be used as the first choice for screening coronary dysplasia.Part ?:Coronary CTA Study of Myocardial Bridge and Its associated coronary atherosclerosisObjective:To explore CTA to evaluate the location,morphological characteristics of myocardial bridge and its correlation with coronary atherosclerosis.Materials and Methods:to retrospectively analyze 244 cases of patients with myocardial bridge by CTA,of which 30 cases were underwent coronary angiography at the same time.The myoccoronary ardial bridge's morphology,course,and the degree of stenosis in adjacent lumen,as well as whether there were plaques were observed to compare the accuracy and difference of coronary CTA and DSA in the diagnosis of myocardial bridge and its complications,so as to conduct statistical analysis.Results:244 cases of myocardial bridge was found by CTA,accounting for 21.1%.superficial type of myocardial bridge was 168 cases,accounting for 68.85%,longitudinal type was 76 cases,accounting for 31.14%.The myocardial bridge located in the left anterior descending branch was 228 cases,with a proportion of 93.44%,of which 177 cases were located in the middle part of the anterior descending branch,10 cases in the circumflex branch with a proportion of 4.09%,2 cases in the first diagonal branch for 0.81%,and 3 cases in the obtuse marginal branch for 1.23%,one cases in the right coronary artery,accounting for 0.41%.Of the 228 cases of LAD myocardial bridge,104 cases were detected with plaque formation at the proximal end of the parietal coronary artery,accounting for 45.61%,and 23 cases at the distal end of the parietal coronary artery with a proportion of 10.08%.The proximal end of myocardial bridge was more likely to develop atherosclerosis,the difference was statistically significant(p<0.05).The detection rate of myocardial bridge by CTA was significantly higher than that by DSA(p<0.05),and there was a statistical significance.The incidence of myocardial bridge with pleurodynia and other clinical symptoms was lower than that of myocardial bridge with no symptoms,the difference was statistically significant(p<0.05).If the results of DSA test were "gold standard",the sensitivity for myocardial bridge complicated with atherosclerotic lumen stenosis by CTA was 85%,coincidence rate was 86.66%,specificity was 90%.Conclusion:The detection rate of myocardial bridge by CTA is significantly higher than that by DSA.Its sensitivity is higher that it can effectively avoid the occurrence of missed diagnosis of the disease,which is the first choice for detecting myocardial bridge;and it can accurately evaluate the types and complications of myocardial bridge.Myocardial bridge can be used as one of the risk factors for evaluating coronary atherosclerotic heart disease. |
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