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你可能喜欢窦房结动脉形态学的320排CT研究
中华临床医师杂志（电子版）
2013年3月,7卷5期
窦房结动脉形态学的320排CT研究
董莘，时文伟，秦崇，敖国昆
100091 北京，解放军第309医院放射科董莘，Email：
摘要:目的 使用320排CT冠状动脉造影(CTCA)研究窦房结动脉的形态特征，并描述其临床意义。方法 回顾性分析3144例患者[男1991例，女1153例，年龄(59±14)岁]的320排CTCA影像资料。由于图像质量不佳，51例患者被排除。根据分别起源于右侧冠状动脉或左回旋支确定为右或左(R或L)窦房结动脉;根据其各自走行于右心耳内侧或右心房的后面确定为R1或R2亚型;根据其各自的走行于左心耳内侧、后侧或左心房的后面确定为L1、L2或L3。然后，每种类型根据走行末端终止于上腔静脉周围的关系再分为上腔静脉前、上腔静脉后和上腔静脉周围型。如果窦房结动脉起源于右侧冠状动脉中段，走行于左心耳内侧，另外增加一个亚型(R1M)。S-型窦房结动脉起源于左旋支，向后走行于左心耳和左上肺静脉开口之间，然后向前终止于左心房的前壁。结果 3093例中共显示窦房结动脉3082例(96.4%)，其中2943例(95.5%)为单支窦房结动脉，1669支(54.2%)起源于右侧冠状动脉，1274支(41.3%)起源于左侧冠状动脉旋支。139例(4.5%)为双支窦房结动脉，并且为左右各1支，分别起源于右侧冠状动脉和左侧冠状动脉旋支。本文最常见的亚型是R1型1753支(54.4%)，其次是L1型805支(25.0%)和L2型551支(17.1%)，少见的亚型包括R2型45支(1.4%)、L3型57支(1.8%)和R1m型10支(0.3%)。3221支窦房结动脉终止类型包括上腔静脉前、上腔静脉后、上腔静脉周围型分别有552支(17.1%)、1836支(57.0%)、833支(25.9%)。不同窦房结动脉起源的终止类型之间差异无统计学意义(χ2=1.32,P=0.25)。右窦房结动脉起点与右侧冠状动脉开口间距离为(13.8±8.4)左侧窦房结动脉起点与左侧冠状动脉回旋支开口间距离为(11.7±6.1)mm，两者差异无统计学意义(t=0.764，P=0.476)。右窦房结动脉直径为(1.66±0.29)mm，左窦房结动脉直径为(1.61±0.26)mm，两者差异无统计学意义(t=0.844，P=0.557)。S型窦房结动脉被发现31例(2%)。结论 320排CTCA描述了窦房结动脉常见的分型，可以为外科和介入手术提供有价值的信息，以避免医源性损伤。显示窦房结动脉的变异相当有效、可靠。
关键词:冠状血管; 血管造影术; 体层摄影术，X线计算机
The morphology of sinuatrial nodal artery on 320-raw computed tomography coronary angiography
DONG Xin,SHI Wen-wei,QIN Chong,AO Guo-kun
Department of Radiology,The 309th Hospital of PLA,Beijing 100091,ChinaDONG Xin，Email：
Abstract:Objective To use 320-raw computed tomography coronary angiography(CTCA)to investigate the morphologic characteristics of the sinoatrial node(SAN)artery and to describe its clinical implications.Methods 320-raw CTCA of 3144 patients[1991 men，1153mean age(59±14)years]were retrospectively reviewed.51 patients were excluded due to poor image quality.According to the origin,number,anatomic course,mode of termination of the SAN artery,each artery was classified into one of following types:right or left(R or L),according to respective origin from the right coronary artery(RCA)or left circumflex(LCX);subtypes R1 or R2,according to its respective course medial to the right auricle or on the posterior surfaceor L1,L2 or L3,according to its respective course,medial,or posterior to the left auricle or,on the posterior surface of the left atrium.Then,each type was subdivided according to the course of the terminal segment around the superior vena cava being precaval,retrocaval,or pericaval.The S-shape SAN artery arises from the posterolateral part of the left circumflex below,or behind the left auricle,and runs posteriorly between the left atrial appendage and the ostium of the left superior pulmonary vein,and then anteriorly close to the anterior wall of the left atrium.Results The SAN artery was visualized in %)of 3093 cases.The SAN artery was being vascularized by a single artery in %)cases and by two arteries in 139(4.5%)cases.It was arising from the RCA in %)cases,from the LCX in %)cases.The most frequent subtype in our study was R1 in %),followed by L1 in 805(25.0%),and L2 in 551(17.1%).The rare subtype in our study included R2 in 45(1.4%)，L3 in 57(1.8%)，and R1m in 10(0.3%).The termination types in the 3221 SAN arteries were precaval in 552(17.1%),retrocaval in %),and pericaval in 833(25.9%).There was no statistically significant relationship between the origin of the SAN artery and the course of the terminal segment(χ2=1.32,P=0.25).The mean distance between the origin of the SAN artery from the RCA and the RCA ostium was(13.8±8.4)mm,from the LCX and the origin of the LCX was(11.7±6.1)mm.The difference was statistically significant(t=0.764，P=0.476).The mean diameter of the SAN arteries was(1.66±0.29)mm in the right and(1.61±0.26)mm in the left.The difference was statistically significant(t=0.844，P=0.557)，S-shaped the SAN artery was determined in 31(2%)cases.Conclusions The 320-raw CTCA depiction of the variable arterial blood supply to the SAN may provide valuable information prior to any planned surgical or catheter-based interventional cardiac procedures in patients.It is considerably effective in depicting the various vascularization types of SAN.
Keywords:C A Tomography，X-ray computed
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　　[1] Deeprasertkul P,Thakur RK.Sinus arrest following right coronary artery stent implantation.Int Arch Med,.:
　　[2] 杨筱茜,李佩玲,于海杰,等.CT血管成像对冠状动脉分叉病变的诊断价值.中华心血管病杂志,-588.:
　　[3] Ozturk E,Saglam M,Bozlar U,et al.Arterial supply of the sinoatrial node:a CT coronary angiographic study.Int J Cardiovasc Imaging,-627.:
　　[4] Okmen AS,Okmen E.Sinoatrial node artery arising from posterolateral branch of right coronary artery:definition by screening consecutive 1500 coronary angiographies.Anadolu Kardiyol Derg,-485.:
　　[5] Ramanathan L,Shetty P,Nayak SR,et al.Origin of the sinoatrial and atrioventricular nodal arteries in South Indians:an angiographic study.Arq Bras Cardiol,-319,330-335,342-348.:
　　[6] Saremi F,Channual S,Abolhoda A,et al.MDCT of the S-shaped sinoatrial node artery.AJR Am J Roentgenol,9-1575.:
　　[7] Ortale JR,Paganoti Cde F,Marchiori GF.Anatomical variations in the human sinuatrial nodal artery.Clinics(Sao Paulo),-558.:
　　[8] Matt D,Scheffel H,Leschka S,et al.Dual-source CT coronary angiography:image quality,mean heart rate,and heart rate variability.AJR Am J Roentgenol,-573.:
　　[9] Zhang LJ,Wang YZ,Huang W,et al.Anatomical investigation of the sinus node artery using dual-source computed tomography.Circ J,5-1620.:
　　[10] Kawashima T,Sasaki H.The morphological significance of the human sinuatrial nodal branch(artery).Heart Vessels,-219.:
　　[11] Saremi F，Abolhoda A，Ashikyan O，et al.Arterial supply to sinuatrial and atrioventricular nodes：imaging with multidetector CT.Radiology，：99-107.:
　　[12] Song YS,Lee W,Park EA,et al.Anatomy of the sinoatrial nodal branch in Korean population:imaging with MDCT.Korean J Radiol,-578.:
　　[13] Busquet J,Fontan F,Anderson RH,et al.The surgical significance of the atrial branches of the coronary arteries.Int J Cardiol,-236.:
(编辑：吴莹 收稿日期：)冠状动脉解剖
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冠状动脉解剖
冠状动脉解剖冠状动脉 Coronary Arteries: BranchesSome of the arteries that extend from the main coronary arteries include:左冠状动脉 Left Main Coronary Artery&- Directs oxygenated blood to the left anterior descending artery and the left circumflex.&冠状动脉 分段CT images of normal heart in 53-year-old man.主动脉根部 Ao = aortic root,冠状窦 CS = coronary sinus, 左心房 LA = left atrium,左前降支 LAD = left anterior descending artery, 左旋支 LCx = left circumflex artery,左冠状动脉主干 LM = left main coronary artery,左心室 LV = left ventricle,后降支 PDA = posterior descending artery,右心房 RA = right atrium,右冠状动脉 RCA = right coronary artery,右心室 RV = right ventricle,右室流出道 RVOT = right ventricular outflow tract. Axial 5-mm maximum-intensity-projection (MIP) image shows left main coronary artery as it arises from left coronary cusp.左冠状动脉LCA(黑箭)，左前降支LAD(白箭头)，左旋支LCx(黑箭头)，右冠状动脉RCA(白箭)&左冠状动脉LCA (黑箭)，左旋支LCx(箭头)，左前降支LAD(白箭)左前降支 LAD(箭头)左前降支 LAD(箭头)室间隔支（黑色箭头），对角支（白色箭头）左前降支（黑箭头），回旋支（白箭头）中间支（对角支）（箭）右冠状动脉（黑箭），动脉圆锥支 （箭头）来自主动脉,锐缘支(白箭)锐缘支(白箭)窦房结支(箭头)圆锥支的解剖变异AO =主动脉根部，LA =左心房，LAD =左前降支，LM =左冠状动脉主干，LV =左心室，RA =右心房，RCA =右冠状动脉，RVOT=右室流出道，SAN =窦房结支。Ao = aortic root, LA = left atrium, LAD = left anterior descending artery, LM = left main coronary artery, LV = left ventricle, RA = right atrium, RCA = right coronary artery, RVOT = right ventricular outflow tract, SAN = sinoatrial node branch.窦房结支的变异：窦房结支（箭头），来自右冠状动脉近端窦房结支（箭头 ），来自左回旋支AO =主动脉根部，D1 =第一对角支，GCV =心大静脉，LA =左心房，LAD =左前降支，LCx =左回旋支，LM =左冠状动脉主干，OM1 =第一钝缘支，RCA =右冠状动脉，RVOT=右室流出道，SVC =上腔静脉。LAD =左前降支，LV =左心室，RCA =右冠状动脉，RV =右心室。右缘支（箭）Ao=主动脉根部，AVN=房室结支，IMB=下缘支，LCx=左回旋支，LV=左心室，PDA=后降支，PLB=后外侧支，RCA=右冠状动脉，RVOT=右室流出道CS =冠状窦，LV =左心室，MCV =心中静脉，PDA =后降支，PLB=后外侧支，PLV=后外侧静脉，RA =右心房，RCA =右冠状动脉，RV =右心室Ao=主动脉根部，AVGA =房室沟动脉，CS =冠状窦，LA =左心房，OM =钝缘支，PDA =后降支，PLB=后外侧支，RA=右心房，RCA =右冠状动脉LV =左心室，PDA =后降支，PLB=后外侧支，RCA =右冠状动脉，RV =右心室左冠状动脉解剖&AVGA=房室沟动脉，PDA=后降支左冠状动脉主干分叉 &AVGA =房室沟动脉，D1 =第一对角支，LAD =左前降支，LCx=左回旋支，LM =左冠状动脉主干，OM1 =第一钝缘支，SAN =窦房结支中间支解剖LAD =左前降支left anterior descending artery，LCx=左回旋支left circumflex artery，LM =左冠状动脉主干left main coronary artery，RI=中间支动脉ramus intermedius artery前降支LA =左心房 left atrium, LV =左心室 left ventricleMyocardial bridge and septal perforator branch&心肌桥和室间隔穿支LA =左心房 left atrium, LAA =左心耳 left atrial appendage, LV =左心室 left ventricle, S1, S2, S3 = first, second, and third septal perforators第一、二、三室间隔穿支，心肌桥覆盖第二室间隔穿支以远左前降支（箭）心肌桥&左前降支（箭）对角支D1 =第一对角支 first diagonal, D2 =第二对角支 second diagonal, LAD =左前降支 left anterior descending artery, LCx =左回旋支 left circumflex artery, LM =左冠状动脉主干 left main coronary artery, LV =左心室 left ventricle, RI =中间支 ramus intermedius artery, SP =室间隔穿支 septal perforator branchesNondominant left circumflex artery anatomyAVGA =房室沟动脉atrioventricular groove artery，CS =冠状窦coronary sinus，D1 =第一对角支first diagonal，GCV =心大静脉great cardiac vein，LAD =左前降支left anterior descending artery，LCx=左回旋支left circumflex artery，OM1 =第一钝缘支first obtuse marginalDominant left circumflex artery anatomyAVGA =房室沟动脉atrioventricular groove artery，LCx=左回旋支left circumflex artery，LM =左冠状动脉主干left main coronary artery，OM1 =第一钝缘支first obtuse marginal，OM2 =第二钝缘支second obtuse marginal，PDA =后降支posterior descending artery，PLB=后外侧支posterior lateral branch，RI =中间支动脉ramus intermedius artery右冠状动脉和左主冠状动脉异常起源&Anomalous origin of right coronary artery and left main coronary arteryAo =主动脉根部 aortic root, LAD =左前降支 left anterior descending artery, LM =左冠状动脉主干 left main coronary artery, RCA =右冠状动脉 right coronary artery, RVOT =右室流出道 right ventricular outflow tract左心室（黑*），左心房（白*），左心耳（白箭），二尖瓣（MV）（黑箭），冠状窦CS（箭头）左心室（大黑*），左心房（小黑*），右心房（RA）（小白*），二尖瓣MV（黑箭），三尖瓣（白箭）和心包（箭头）
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