摘要
【目的】分析左冠状动脉异常起源于肺动脉(ALCAPA)综合征的多排螺旋CT冠状动脉成像(MDCTCA)表现并复习文献,以期提高对该综合征的认识。【方法】对3例经手术证实的ALCAPA综合征患者的CTCA表现和临床资料进行回顾性分析。3例患者均于术前行CTCA检查,其中2例于术后各复查1次CTCA。【结果】3例患者术前CTCA检查均可清晰显示左冠状动脉起源于肺动脉,与术中所见相符;其中2例患儿出生后不久开始出现心功能不全症状,CTCA示双侧冠状动脉未见扩张,左心室增大,符合"婴儿型";1例患儿婴儿期无症状,CTCA可见右侧冠状动脉主干及分支扩张迂曲,左、右冠状动脉间见多条侧枝血管吻合,符合"成人型";1例患者合并动脉导管未闭及永存左上腔静脉,1例合并左肾重复畸形。【结论】CTCA技术是ALCAPA综合征诊断、分型及术后随访的重要手段。
【Objective】 The purpose of this study was to obtain a better understanding of the anomalous origin of the left coronary artery from the pulmonary artery（ALCAPA） syndrome by analyzing the manifestations of this syndrome on multi-detector computed tomography coronary angiography（MDCTCA） and literature review.【Methods】 Retrospective analysis of the CTCA manifestations and clinical materials was conducted in 3 surgical confirmed cases of ALCAPA syndrome,all of which received CTCA examinations preoperation and 2 cases had follow-up CTCA post-operation.【Results】 All the preoperative CTCA of the 3 cases clearly depicted the anomalous left coronary artery originating from the pulmonary artery.2 of the cases began to show symptoms of cardiac deficiency soon after birth.Their CTCA revealed dilated left ventricle with normal size coronary arteries,which were in accordance with infant-type.1of the cases was asymptomatic during infancy.CTCA revealed dilated and twisted right coronary artery with multiple collateral vessels between the left and right coronary arteries,which was in accordance with adult type.1 case was complicated by patent ductusarteriosus and persistent left superior vena cava.1 case had duplex left kidney and ureter.【Conclusions】 CTCA technique is preferable in the diagnosis,categorization and post-operative follow-up of ALCAPA syndrome.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2015年第1期154-160,共7页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
冠状动脉异常起源
多层螺旋CT
冠状动脉造影
心肌梗死
anomalous origin of coronary artery
multi-detector computed tomography
coronary angiography
myocardial infarction
