冠脉造影体位与血管识别

ClinicalTrainingMaterialCoronaryAngiographyAbbottVascular，China冠状动脉造影CoronaryAngiography1左冠状动脉LeftCoronaryArtery(LCA)¾各血管名称¾投照体位2前后位AnteriorPosteriorProjection(AP)1.左主干LeftMain(LM)2.前降支LeftAnteriorDescending(LAD)3.对角支DiagonalBranch(DX)4.间隔支SeptalPerforator(SP)5.回旋支Circumflex(LCX)6.钝缘支ObtuseMarginal(OM)3左冠状动脉LeftCoronaryArtery(LCA)¾各血管名称¾投照体位4左前斜+头位LeftAnteriorOblique(LAO55°)+Cranial(CRAN20°)1.左主干LeftMain(LM)2.间隔支SeptalPerforator(SP)3.前降支LeftAnteriorDescending(LAD)4.对角支DiagonalBranch(DX)5.钝缘支ObtuseMarginal(OM)6.回旋支Circumflex(LCX)5左冠状动脉LeftCoronaryArtery(LCA)¾各血管名称¾投照体位6左侧位LeftlateralProjection1.左主干LeftMain(LM)2.前降支LeftAnteriorDescending(LAD)3.对角支DiagonalBranch(DX)4.间隔支SeptalPerforator(SP)5.钝缘支ObtuseMarginal(OM)6.回旋支Circumflex(LCX)7左冠状动脉LeftCoronaryArtery(LCA)¾各血管名称¾投照体位8左前斜LeftAnteriorOblique(LAO55°)1.左主干LeftMain(LM)2.间隔支SeptalPerforator(SP)3.前降支LeftAnteriorDescending(LAD)4.对角支DiagonalBranch(DX)5.回旋支Circumflex(LCX)6.钝缘支ObtuseMarginal(OM)9左冠状动脉LeftCoronaryArtery(LCA)¾各血管名称¾投照体位10右前斜RightAnteriorOblique(RAO30°)1.左主干LeftMain(LM)2.前降支LeftAnteriorDescending(LAD)3.回旋支Circumflex(LCX)4.对角支DiagonalBranch(DX)5.间隔支SeptalPerforator(SP)6.钝缘支ObtuseMarginal(OM)11右冠状动脉RightCoronaryArtery(RCA)¾各血管名称¾投照体位12左侧位LeftlateralProjection1.动脉圆锥支ConusBranch2.窦房结支SinusNodeArtery(SA)3.右室支RightVentricularBranch(RVB)4.锐缘支AcuteMarginal(AM)5.后侧支PosteriorLateralBranch(PLA/PLB)6.后降支PosteriorDescendingArtery(PDA)13右冠状动脉RightCoronaryArtery(RCA)¾各血管名称¾投照体位14右前斜RightAnteriorOblique(RAO45°)1.窦房结支SinusNodeArtery(SA)2.动脉圆锥支ConusBranch3.右室支RightVentricularBranch(RVB)4.锐缘支AcuteMarginal(AM)5.后侧支PosteriorLateralBranch(PLA/PLB)6.后降支PosteriorDescendingArtery(PDA)15右冠状动脉RightCoronaryArtery(RCA)¾各血管名称¾投照体位16左前斜+足位LeftAnteriorOblique(LAO45°)+Caudal(CAU15°)1.动脉圆锥支ConusBranch2.窦房结支SinusNodeArtery(SA)3.右室支RightVentricularBranch(RVB)4.后侧支PosteriorLateralBranch(PLA/PLB)5.锐缘支AcuteMarginal(AM)6.后降支PosteriorDescendingArtery(PDA)1718冠状动脉供血区域¾左前降支(LAD)o左室前壁o左室侧壁o心尖部o室间隔¾左回旋支(LCX)¾右冠状动脉(RCA)o右心房o右心室o左室后壁o左室下壁（右侧优势型）o左心房o左室后壁o左室侧壁o左室下壁（左侧优势型）冠状动脉造影识图小窍门¾一般常识o左前斜位(LAO)：脊柱位于图像右侧，心尖指向左侧o右前斜位(RAO)：脊柱位于图像左侧，心尖指向右侧o肋骨与脊柱相连，向前下方走行，如果在图像中看不到脊柱，可根据肋骨的走行方向判断脊柱的位置o主动脉沿脊柱自下而上走行，导引导管走在其中（股动脉入路），故导引导管在图像的部位总与脊柱一致¾右冠状动脉(RCA)o左前斜位：形状似“C”o右前斜位：形状似“L”19冠状动脉造影识图小窍门¾左冠状动脉(LCA）o回旋支(LCX))永远最靠近脊柱o左前斜位(LAO)：前降支(LAD)位于图像左侧，间隔支(SP)从前降支左侧发出向左下走行，对角支(DX)从前降支右侧发出向右下走行o右前斜位(RAO)：前降支(LAD)位于图像上部，间隔支(SP)垂直于前降支发出向下走行，o左侧位：前降支(LAD)与回旋支(LCX)勾勒出心脏的轮廓2021