冠心病室壁瘤的CT影像学表现

6。PCI。1LLOYDJONESDADAMSＲJBＲOWNTMetal．Heartdis-easeandstrokestatistics———2010updateareportfromtheAmer-icanHeartAssociationJ．Circulation20101217e46－e215．2HEPEＲGKOＲKMAZMEKILICA．Ｒeperfusionarrhythmiasaretheyonlymarkerofepicardialreperfusionorcontinuingmyo-cardialischemiaafteracutemyocardialinfarctionJ．Angiolo-gy2007586663－670．3VANDEWEＲFF．ThrombolysisforacutemyocardialinfarctionwhyistherenoextrabenefitafterhospitaldischargeJ．Circu-lation199591122862－2864．4．J．2003123165－167．5．J．2012213188190．6ENGELENDJGＲESSINVKＲUCOFFMWetal．Usefulnessoffrequentarrhythmiasafterepicardialrecanalizationinanteriorwallacutemyocardialinfarctionasamarkerofcellularinjurylead-ingtopoorrecoveryofleftventricularfunctionJ．AmJCardiol200392101143－1149．7CLAEYSMJBOSMANSJVEENSTＲALetal．DeterminantsandprognosticimplicationsofpersistentST－segmentelevationaf-terprimaryangioplastyforacutemyocardialinfarctionimportanceofmicrovascularreperfusioninjuryonclinicaloutcomeJ．Circu-lation199999151972－1977．8SCHＲODEＲＲWEGSCHEIDEＲKSCHＲODEＲKetal．Ex-tentofearlyST－segmentelevationresolutionastrongpredictorofoutcomeinpatientswithacutemyocardialinfarctionandasensitivemeasuretocomparethrombolyticregimensJ．JAmCollCardiol19952671657－1664．2013－07－16CT梁韬，陈晓亮，吴菊芳，陈志军518033【】探讨冠心病室壁瘤(LVA)的64层螺旋CT影像学表现，以提高对该疾病的诊断鉴别水平。回顾性分析经临床证实的27例LVA患者的CT血管造影检查资料，对LVA的部位、瘤壁运动、形态、大小、瘤壁厚度及附壁血栓进行评估。27例LVA中，左冠前降支供血区域19例，左冠回旋支供血区域7例，右冠供血区域1例。LVA局部室壁运动明显减低、无运动10例;反常运动17例。LVA局部心室壁向外膨隆、扩张。瘤颈与瘤体最大径比平均值为0.87。LVA瘤壁密度减低并且瘤壁变薄。LVA合并附壁血栓6例，伴瘤壁心肌钙化3例。64层螺旋CT可对冠心病LVA相关特点等进行评估，为临床治疗方案的制定提供有价值的图像和参数。【】室壁瘤;64层螺旋CT;冠心病leftventricularaneurysmLVALVA、、。CTLVA27LVA64CTLVA。11．1一般资料2007120121264CTCTA27LVA19846～7761.3±14.9。、。18。1．2方法1．2．164层螺旋CTA成像及重建方法SiemensSensation64CT。130kV900mAs0.6mm0.20.33s/360°B25f5～10s。10%Ｒ－Ｒ5mm10。multi－planarreformationMPＲvolumerenderingVＲLVA。0.75mmMPＲLVALVA。·4463·2013123423GuangdongMedicalJournalDec．2013Vol．34No．23maxi-mumintensityprojectionMIP、MPＲVＲ。1．2．2室壁瘤的诊断标准CASS1。、Ⅲ～Ⅳ、＜40/min、。1．2．3LVA发病部位的定位2002/AHA/ACC216。1．2．4LVA的分类4LVA＜5cmLVA≥5cm＜8cmLVA8～12cmLVA＞12cm。24hLVA15dLVALVA。22．1LVA发生部位及受累范围1971。LVA9－4－2213－1－121－1。2717641。2．2动态心脏电影LVA、1017。2．3LVA形态、大小、0.871～2。27LVA25LVA2LVA24.3mm。2．4LVA瘤壁LVA3。3.1mm1.1mm。LVA4。LVA5。2．5LVA附壁血栓LVA663。ALVA、BLVA0.59CLVA、DLVAELVAFLVA、1LVACT33．1LVA概述、LVA。LVA、、、、。·5463·2013123423GuangdongMedicalJournalDec．2013Vol．34No．233．2LVA与血管关系27LVA1970.3%。27LVA17LVA1。3．3LVA室壁运动分析CTLVA、1017LVA。LVA、3－4。CTVＲMPＲLVACT。3．4LVA的形态特征27LVA0.87LVA0.55－6。3．5LVA的径线与临床MPＲVＲLVA。252LVA。LVA。、5cmLVALVALVA7。3．6LVA瘤壁的影像学意义LVA、8LVACTA。LVA、。3.1mm1.1mm。MPＲLVA。LVALVA3LVALVA5。MPＲLVA。LVA、、LVA6。3．7LVA瘤壁的血检与钙化LVA63。LVA、。、LVA。LVALVALVA、7。CTMPＲVＲ、CTLVA。CTLVA、、、、、LVA。1．J．2007235386－387．2JENKINSCBＲICKNELLKCHANJetal．Comparisonoftwo－andthree－dimensionalechocardiographywithsequentialmagneticresonanceimagingforevaluatingleftventricularvolumeandejec-tionfractionovertimeinpatientswithhealedmyocardialinfarctionJ．AmJCardiol2007993300－306．3ANYNAGASHIMAMYAMAZATOSetal．Ventriculartachy-cardiaoriginatingfromaheart－shapedidiopathicleftventricularaneurysmdiagnosedonathree－dimensionalelectroanatomicalmappingsystemintegratedwithCTimagingJ．InternMed20135221347－1352．4PAPAGIANNISJVANPＲAAGHＲSCHWINTOetal．Con-genitalleftventricularaneurysmclinicalimagingpathologicandsurgicalfindingsinsevennewcasesJ．AmHeartJ20011413491－499．5．J．2006136369－373．6SHETTYD．J．2004114290－291．7．M．200688－92．8．64CT－SPECJ．200622101460－1463．2013－02－22·6463·2013123423GuangdongMedicalJournalDec．2013Vol．34No．23