【摘要】 目的 探讨256层CT血管成像(CTA)对冠状动脉瘘(CAF)的诊断价值。方法 回顾性分析CAF 18例，对原始图像进行多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)及容积重建(VR)等后处理。结果 18例CAF中冠状动脉分支血管瘘入肺动脉5例；瘘入冠状静脉窦5例；瘘入右心房3例；瘘入左心房3例；瘘入右心室2例。5例冠状动脉肺动脉瘘可观察到畸形血管向肺动脉内供血，肺动脉主干内均可见对比剂呈“喷射”或“浓染”征。主肺动脉旁形成丛状或蔓藤状血管网2例。供血动脉区动脉瘤形成3例。结论 256层冠状动脉CTA能准确显示CAF变异血管的解剖细节及血流动力学改变情况，运用多种重建技术能够直观地显示CAF的畸形血管形态。更多还原

【Abstract】 Objective To investigate the clinical value of 256-slice CT angiography(CTA) in diagnosing coronary artery fistula(CAF).Methods A total of 18 patients with CAF were analyzed retrospectively.The raw data were transferred to the work station.Image reconstruction techniques were employed,including multiplanar reconstruction(MPR),curved planar reconstruction(CPR),maximum intensity projection(MIP) and volume render(VR).Results Coronary artery angiography showed fistula affluxed to the pulmonary artery in 5 cases,affluxed to the coronary sinus in 5 cases,affluxed to the right atrium in 3 cases,affluxed to the left atrium in 3 cases,affluxed to the right ventricle in 2 cases.The blood flow from abnormal vessels to pulmonary arteries was demonstrated in5 patients,and "injection" sign or "hyper-density" of contrast material in the main pulmonary artery was seen.The tortuous vascular networks on the surface of the main pulmonary artery trunk were seen in 2 cases.Formation of aneurysm was seen in 3 cases.Conclusion256-slice CTA can precisely show the detailed anatomy variations and heomodynamic information of CAF,and directly display the abnormal vessels with multiple image reconstruction techniques.更多还原