【摘要】 目的探讨窦房结动脉和房室结动脉的双源CT(DSCT)冠状动脉成像形态学特征。方法应用DSCT对272例患者行冠状动脉成像,测量窦房结和房室结动脉的直径、右SNA起点与RCA开口及左SNA起点与LCX起点的距离、AVNA与冠状静脉窦的距离。观察记录窦房结和房室结动脉起源、数量、行径及和周围结构的解剖关系。结果①单支SNA中起源于RCA近段0～33 mm范围内的155例,起自LCX近段4～31 mm范围内100例;14例为两支窦房结动脉。②起源于LCX外后侧段的19例窦房结动脉呈"S"型走形,在左上肺静脉与左心耳之间的间隙内穿行。③SNA末段进入窦房结的途径有三种方式:SVC前型(50.00%)、SVC后型(41.54%)、Y型包绕(8.46%)。④AVNA起源于RCA 244例,起源于LCX 28例,6例为2支AVNA供血,均发自RCA。⑤AVNA的直径为(1.19±0.62)mm。AVNA与CSO的距离为(3.75±0.29)mm。结论窦房结动脉、房室结动脉解剖变异较大,DSCT可准确显示其解剖特点。更多还原

【Abstract】 Objective To investigate the morphologic features of sinuatrial nodal artery(SNA)and atrioventricular nodal artery(AVNA)with dual-source CT(DSCT)coronary imaging.Methods A total of 272 patients underwent DSCT coro- nary angiography.The diameter of the SNA and AVNA,the distance from the origin of right SNA to the right coronary ar- tery(RCA)ostium and left SNA to the left circumflex(LCX)artery ostium,and the distance from AVNA to the coronary sinus ostium(CSO)were measured.Anatomic origin,number,course,and around the anatomical structure of relations of the SNA and AVNA were observed and recorded.Results①A single SNA originated from the proximal 0-33 mm of the RCA in 155 and from the proximal 4-31 mm of the LCX artery in 100 patients.Dual blood supply to the sinuatrial nodal was seen in 14 patients.②An S-shaped variant was seen in 19 of left SNA and traveled in the sulcus between left superior pulmonary vein and atrial appendage.③The SNA approached the tissue by one of three routes:retrocaval(50.00%),pre- caval(41.54%)or pericaval(8.46%).④The AVNA arose from the distal RCA in 244 patients and from the distal LCX ar- tery in 28 patients.Dual blood supply to originating from the distal RCA was observed in 6 patients.⑤The diameter of the AVNA was(1.19±0.62)mm.The distance from the AVNA to the CSO was(3.75±0.29)mm.Conclusion The SNA and the AVNA are variable.DSCT image may correctly depict the anatomic characteristic of SNA and AVNA.更多还原