爱爱医资源冠脉cta冠脉解剖课件

《爱爱医资源冠脉cta冠脉解剖课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、CoronaryCTA:coronaryanatomy&terminology-Acardiologist’sperspectiveJuileMillerMDAssistantprofessorofMedicineInterventionalCardiologyJohnsHopkinsUniversity冠脉CTA：冠脉解剖JuileMillerMDAssistantprofessorofMedicineInterventionalCardiologyJohnsHopkinsUniversityArteryDescriptionOrigin:Originatingcusp/sinus

2、ofvalsalvaCourseBranchnameSize(caliberanddistribution):smallmediumlargeDominanceAdequacyofimagequalityforinterpretationoverall，pervessel，persegment动脉的描述起点：起始点/valsalva窦行程分支名称大小（口径及分布）：小、中、大支配区域合适的图像质量：总体，每条血管，每个层面NormalLeftMain(LM)Origin-leftsinusvalsalva-Absentin1%Separate,adjacentLADLCXostia-

3、0.5%Branches:LAD&LCX=85%LAD,LCXandRamus10-15%Criticalissues:－stenosisduetoriskregion－Presenceofostialdisease－Other:aneurysmsanomaloustakeoff左冠状动脉主干（LM)起点：左valsalva窦（左冠窦）1％例外直接分出LADLCX占0.5％分支：分出LADLCX占58%LAD,LCX和中间支10-15%关键问题：狭窄致局部供血不足冠状动脉口疾病动脉瘤，（内膜）不规则剥离LeftAnteriorDescending(LAD)Origin:-FormLe

4、ftMain95-99%-1-3%separateostiumLeftsinusCourseAnteriorintraventriculagroovetowardapex2variationsinterminationBranches:DiagonalsseptalperforatorsCriticalissuesPresenceofostial/proximaldiseaseMyocardialbridgesOther:aneurysmsanomaloustakeoff左前降支（LAD）起点：95－99％起源于LM1-3%直接开口于左冠窦行程：心室前方经室间沟达心尖最后分为两支分支

5、：角支室间隔支关键问题：冠状动脉近端或冠状动脉口疾病心肌桥动脉瘤，（内膜）不规则剥离NormalAnrtomy（LAD)LeftCircumflex(LCX)Origin:OriginatingformLMin96-98%5-2%separateostiumLCXoriginformrightsinusorRCA(0.4%)Course:downdistalleftAVgrooveBranchesobtusemarginalbranchesLeftposterior-lateral:definebyacutemarginandsupplyPLwallLeftposteriordesc

6、ending(ifdominant)Criticalissuesdominance(15-20%)起点：96-98%起源于LM5-2%单独开口LCX起源于右冠窦或RCA约0.4%行程：沿着左房室沟下降分支：钝缘支左后外侧支（营养后外侧壁）左后降支(左侧优势）关键问题：左侧优势（15%-20%)NormalAnatomy(LCX)NormalAnatomy(LCX)Ramusintermedius（中间支）NormalRightcoronaryartery(RCA)Origin:rightsinusofvalsalva(lowerthanLM)AnomalousformLSV=0.1

7、%Course:downdistalrightAVgroovetowardcruxofheartBranchesRightposteriordescending(85%)AcutemarginalbranchesRightposteriorlateralCriticalissues:dominance(15-20%)右冠状动脉(RCA)起点：左valsalva窦（右冠窦）0.1%起源于左心室行程：沿右房室沟下降至房室交点分支：后降支PDA（85%）锐缘支A