目的比较64排128层CT冠状动脉 血管成像(CTA)诊断心肌桥-壁冠状动脉 (MB-MCA)与冠状动脉造影(CAG)诊断心肌 桥的价值。方法 整理2009年12月--2011 年01月间，在我院做CT冠状动脉血管成像 的病例，共206例，CTA诊断心肌桥病例41 例，其中22例行DSA下进行冠状动脉造影 (CAG)检查。分析CTA与CAG对MB影像学表 现，评估MCA的狭窄程度。结果 CTA诊断 的41例心肌桥病变血管44支，深肌桥36 支，浅肌桥8支，其中22例CAG检查MB，检 出19例，病变血管19支，未检出3例(CTA 表现为前降支浅肌桥)；CTA诊断41例MB， MCA狭窄程度均小于50%，CAG诊断MB，MCA 狭窄程度分别为：小于等于50%，9例， 大于50%小于等于75%，6例，大于75%小 于100%，4例。结论 64排128层CTA诊断 MB-MCA即可以观察到MCA，也能观察到MB, 同时可以观察到肌桥的厚度（即MCA的深 度），但是所观察到的MCA狭窄程度与CAG 观察到的有差异。CAG可在动态下观察到 MCA的狭窄程度，对MCA的狭窄有准确的判 断，但是CAG不能观察到MB。CTA和CAG诊 断心肌桥是互补的，对心肌桥的诊断应为 即能观察到MB，又能观察到MCA并准确判 断其狭窄程度，才是最准确的诊断。

Objective To compare the diagnostic value of 64-slice CT coronary angiography (CTA) and coronary angiography (CAG) in myocardial bridge (MB) and mural coronary artery (MCA). Methods The imaging manifestations of CTA in 206 cases between December 2009 and January 2011 were retrospectively analyzed, 22 of whom underwent the CAG examination. The number of MB and MCA and the degree of stenosis of the MCA were evaluated. Results Forty-four vascular lesions in 41 patients were found by CTA, including 36 deep MB and 8 shallow MB. Nineteen vascular lesions in 19 patients were observed by CAG while no lesions were detected in two cases (CTA showed shallow MB of LAD). In 41 MB diagnosed by CTA, the degree of MCA stenosis was less than 50%. In 19 MB diagnosed by CAG, the degree of MCA stenosis were less than or equal to 50% in 9 cases, more than 50% and less than or equal to 75% in 6 cases, greater than 75% in 4 cases. Conclusion By application of 64-slice CTA, the MB-MCA can be observed but the observed MCA stenosis observed is different from CAG. CAG can observe dynamically the degree of stenosis of the MCA. Combination of CTA and CAG is the most accurate diagnosis for MB and the stenosis degree of MCA.