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1-Beat：左冠状动脉先天变异 Congenital Anomalous Course of Left Coronary Artery
作者：Fran Mikulicic, M.D.（苏黎世大学核医学科，瑞士） 翻译：李武 刘华阳 审校：任心爽 吕滨（中国医学科学院阜外心血管医院）
病史 Patient History 男，40岁，不典型胸痛，伴有冠心病风险的增高，做心脏CT用于风险分级。 A man in his 40s with elevatedcoronary risk profile and atypical chest pain was referred to CT for risks tratification.
Revolution CT采集参数 1-beat 心脏成像（图1） 160mm轴扫门控 100 kV，256mA 体重指数BMI：26 采用ASiR-V 降低剂量 转速0.28s/rot 心率范围：69-72BPM DLP：37mGy*cm 有效吸收剂量：0.52 mSv
图1: 1-beat 心脏采集
结论 本例先天性左冠状动脉异常是左冠状动脉主干和右冠状动脉共同起源于右冠瓣，左主干的一段走形于主动脉和肺动脉之间。（图2） This congenital anomaly of the left coronary artery reveals a joint origin of the LMA and RCA from the right coronary cusp withinterarterial course of the left main artery.
这种罕见的变异与心源性猝死相关，尤其是剧烈运动中的心源性猝死相关。 This rare anomaly is associated with sudden cardiac death particularly during strenuous exercise.
进一步评估此病例可采用SPECT负荷心肌显像。 For further evaluation a myocardial SPECT with exercise stress testing is planned to evaluate the relevance of the finding in this particular case.
图2: CCTA图像
Fran Mikulicic医生的评价 “要感谢单心动周期采集技术和ASiR-V 技术，让我们可以用极低的剂量对高心率患者进行心脏检查，并且得到准确的诊断结果”。 Thanks to the one-beat cardiac acquisition and ASiR-V, aconfident and reproducible diagnosis of coronary arteries can be performed withvery low dose, even at high heart rates.
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