Myocardial Perfusion Imaging and Coronary CT Angiography for Left Main Coronary Artery Aneurysm

左主冠狀動脈瘤：核子醫學心肌血流造影與X光電腦斷層冠狀動脈血管造影的表現

路景竹(Ching-Chu Lu) ； 顏若芳(Ruoh-Fang Yen) ； 吳彥雯(Yen-Wen Wu) ； 黃博昭(Por-Jau Huang) ； 李文正(Wen-Jeng Lee)

《核子醫學雜誌》 21卷3期 (2008/09) Pp. 191-195

https://doi.org/10.6332/ANMS.2103.009

摘要

X光電腦斷層冠狀動脈血管造影目前已成爲一個非侵襲性評估冠狀動脈疾病之有用工具。然而X光電腦斷層冠狀動脈血管造影所得到之解剖資訊較難用來評估心肌缺氧之功能面及預後面。相反的，同位素心肌血流單光子斷層造影在冠狀動脈疾病功能面的評估的效益則已是眾所公認的。所以結合X光電腦斷層冠狀動脈血管的解剖造影加上同位素心肌血流的功能造影能提供最完整冠狀動脈疾病的評估。本病例報告描述一位病人，X光電腦斷層冠狀動脈血管造影發現他的左主冠狀動脈有一個動脈瘤，履帶踏步鉈－201心肌血流造影則顯示心臟中隔有缺氧變化。之後心導管也證實X光電腦斷層冠狀動脈血管造影之診斷。該病人出院復繼續使用藥物治療並在門診密切追蹤已超過兩年。

關鍵字

左主冠狀動脈 ； 動脈瘤 ； 鉈－201心肌血流造影 ； X光電腦斷層冠狀動脈血管造影

並列摘要

CT angiography (CTA) has now become one of the effective tools in evaluating coronary artery disease noninvasively. Nonetheless, the anatomical information from CTA is of little use in diagnosing the functional and prognostic aspects of myocardial ischemia. On the other hand, radionuclide myocardial perfusion imaging (MPI) using single-photon computed tomography (SPECT) is a well established modality for the functional assessment of coronary artery disease (CAD). The combined results of CTA and MPI may offer the best assessments of CAD at present. We present a case of small left main coronary artery aneurysm which was initially diagnosed on CTA. A treadmill stress 201Tl myocardial perfusion imaging revealed mild reversible ischemia in the septum, and subsequent coronary angiography confirmed the finding of CTA. This patient had been medically treated and followed up closely for more than two years.

並列關鍵字

left main coronary artery ； aneurysm ； 201TI myocardial perfusion imaging ； CT angiography