您的当前位置：首页冠脉CTA的技术和解剖

冠脉CTA的技术和解剖

来源：客趣旅游网

Coronary CTA: Coronary

Anatomy & Terminology-A

Cardiologists Perspective^ A.

Julie Miller. MD. F.A.C.C/ :

Assistant Professor of Medicine Inten/entional Cardio

「N

如果要描述一个动脉，需要描述它的起始，走行，分支名称，大小（包括管径和分布范围），优势类

Johns Hopkins Universrty ■ ■

型，并对图像质量进行评价（这在冠脉成像应用普遍，但是在其它地方，一般不在报告里面进行评价

Artery Description

•Size (caliber and distribution)

• •	-Small, Medium, Large Dominance Adequacy of image quality for interpretation 一

Overall,per vessel, per segment

DXY.CN

中间支的图像

Ramus Intermedius

su淋购* y

DXY.CN
Courtesy Dr Jones 8 Partner. Australia

右侧冠状动脉起自右侧冠状窦，位置上低于左侧冠状动脉，有0.1%的病例起于左侧冠状动脉窦。走行沿

着右侧房室沟，走向房室交界点。

85%的病例发出后后降支

15~20 %的病例为右侧优势类型Normal Right Co「ona「y Artery,有边缘支和右侧后旁支。

一 Down right AV grove toward crux of heart.

・ Branches

一 Right posterior descending (85%)

-Acute Marginal branches

一 Right posterior-lateral

■ Critical issues

一 Dominance (15-20%)

DXY.CN

正常右侧冠状动脉的解剖

Normal Anatomy (RCA)

正常右侧冠状动脉的曲面重建

Normal Anatomy (RCA)

其它的分支有

窦房结动脉，约60%来自于右侧冠状动脉，约40%来自于左侧冠状动脉

房室结动脉，右侧冠状动脉

动脉圆锥支，起自右侧冠状动脉的近端，很多病例为单独起源，可以供应侧壁交通支。

Artery Description

• Origi n

-OriginatingCusp / sinus of Valsalva
•Course
•Branch name
•Size (caliber and distribution)
-Small,Medium, Large

• Domina nee

• Adequacy of image quality for interpretation

一 Overall, per vessel, per segment

DXY.CN

右侧优势型

RightDominance

左侧优势型

DXY.CN

Left Dominance

描述病变，需要描述病变发生的位置（起始部，近端，中间部，远侧端），分

叉，长度（狭窄时,小于10cm为局限，离散型，大于20mm为弥漫性，大范

围）、偏心性还是中心性，有无扭曲，有无栓子，软斑块和钙化，有无溃疡

穿孔等

Artery Description

• Branchi name
•	Size (caliber and distribution)

• •	-Small, Medium, Large Dominance Adequacy of image quality for interpretation

一 Overall, per vessel, per segment

DXY.CN

前降支的弥漫性病变

Diffuse LAD Disease

局限的溃疡性斑块

Focal Ulcerated Plaque

Coronary Anomalies

Benign (0.5-1%) (80% of anomalies)

-Separate LAD/LCX ostia

一 LCX origin from RSV or RCA

・ LCX courses behind aorta

一 Anomalous origin from aorta

-High anterior origin of RCA.

・LM

一 Small fistula

Potentially serious (20% of anomalies)

-Origin of CA from opposite aortic sinus (.1- 2%)

一 Anomalous origin from PA (.01%)

一 Multiple or Large coronary

冠脉的异常

fistulae 一 Single Coronary artery

DXY.CN

冠脉的异常类型

Co「onary Anomalies

vnt LM TTunH (vpanh

Monnal Md tim;

LACVLCX ocium)		LCi turn Hoh toon> nac Bl nu c
LACVLCX ocium)

■ ^1^|T1

RCA turn LeftBlnuG

IM trim raghtCnranac Blnuc

DXY.CN™

AfooWetf 加刖 Roberts. W, AM J Cap、7992

Absent Left Main左侧主动脉干缺如

(Separate LAD/LCX origins)

异常的右侧冠状动脉

Anomalous RCA

异常的左冠动脉干

Anomalous LM from RSV

结束了，总结。

DGA

CONCLUSIONS

■ Knowledge of normal cardiac, coronary artery and coronary venous anatomy, as well as knowledge of pathologic changes are important in interpretation of CTA.
•	Angiographic interpretation should in elude assessment of adequae" of
image for evaluation of each artery/segment.
•	Each artery should be examined for its origin, course, size, branches,
and abnormalities/lesions.
•	A comprehensive and clinically-useful MDCTA study should
incorporate an understatiding of the patient history, reason for test, assessment of study quality for all arteries/structures assessed, as well as a full description of findings.

DXY.CN