无顶冠状静脉窦综合征的多层螺旋CT诊断价值

Objective To investigate the characteristic findings of multi-slice spiral CT (MSCT) and its clinical value for unroofed coronary sinus syndrome(UCSS). Methods MSCT images of 13 patients with UCSS confirmed by surgery or images combined with clinical symptoms were analyzed retrospectively,including the defect size,location,coronary sinus diameter and associated cardiac malformation,which were all compared with transthoracic echocardiography.Transverse images combing with various reconstructions,such as multi planar reconstructions,volume rendering tedinique,maximum intensity projection,show the enlarged coronary sinus and the shunt flow.Another 20 normal subjects were included and the results of measurement were compared with UCSS patients.Results The diagnostic accuracy of MSCT for UCSS was 100% (13/13),but the transthoracic echocardiography was 40%(5/13).Seven patients were diagnosed as completely unroofed coronary sinus.Three patients were diagnosed as partially unroofed coronary sinus in the mid-portion,the rest 3 patients were diagnosed as partially unroofed coronary sinus in the terminal portion.In the patients with UCSS,the mean diameter of the coronary sinus was (18.7±10.0) mm,which was significantly greater than the normal group［(8.7±1.6) mm,P<0.05］.The coronary sinus view in the plane of the atrioventricular groove is most suited for depiction of the anatomy of the coronary sinus defect and the shunt between left atrium and coronary sinus.Conclusions Contrast-enhanced MSCT was useful for the diagnosisof UCSS,which could demonstrate the special location and characteristic CT features of UCSS.