目的应用64排128层螺旋CT进行 冠状动脉成像检查，检出冠状动脉起源异 常的病例，分析其与心肌缺血的关系。 方法 收集整理我院2010年1月-2014年5 月在我院行64排128层CT冠状动脉成像检 查的病例，共3231例，其中冠状动脉起源 异常的病例27例，男17例，女10例，其发 生率占0.83%。结果 有27例冠状动脉起源 异常，右冠状动脉起源异常20例，占异 常比例为74.07%，以起源在左冠状窦为 主，有17例，左冠状动脉起源异常6例， 占22.22%，起源左右冠状窦5例，起源于 肺动脉1例，多发异常1例。结论 单纯性 冠状动脉起源于主动脉，在不合并冠状动 脉狭窄及斑块等病变的，通常不引起心肌 缺血改变，起源于肺动脉，有心肌缺血改 变。

Objective Application of 64-slice 128-slice spiral CT coronary artery imaging, detection of anomalous origin of coronary artery cases, analyze its relationship with myocardial ischemia. Methods Collected in our January 2010 to May 2014 in our 64- 128-slice CT coronary angiography examination of cases, a total of 3231, of which 27 cases of abnormal coronary arteries open, 17 men, 10 women, the incidence of 0.83%. Results There were 27 cases of abnormal coronary arteries open, right coronary artery opening 20 cases, exception for 74.07%, dominated by openings at the left coronary cusp, with 17 cases, 6 cases of left coronary artery opening, 22.22%, shedding about 5 cases of the coronary sinus, opening on 1 cases of pulmonary artery, multiple exceptions 1. Conclusions Opening of isolated coronary artery in aorta, without coronary stenosis and plaque lesions, usually without causing a change of myocardial ischemia, openings in the pulmonary hypertension, myocardial ischemia.