目的 探讨冠状动脉CT血管成像（Coronary Computed Tomography Angiography，CCTA）对冠状动脉起源异常 （Anomalous Origin of Coronary Artery，AOCA）的诊断及解剖形态特征的评估价值。方法 分析我院2014年1月至2019年12月 成功行CCTA的影像资料，通过利用CT原始数据在后处理软件最大密度投影、多平面重建、曲面重组和容积再现等多种技 术结合下，观察AOCA及走行的解剖结构。结果 在分析的7235例CCTA中，检出AOCA 87例，检出率为1.2%，AOCA中冠 脉起源于异常冠状动脉窦（34例）是最常见的变异类型，其次为高位起源及左主干缺如（30例、21例），起源于肺动脉及 单支冠状动脉罕见（各1例）。53例AOCA伴随高危解剖结构，分别见于高位起源及起源于异常冠状动脉窦丨且右侧冠状动 脉起源变异伴随高危解剖结构的发生率大于左冠脉起源变异，差异有统计学意义。结论 CCTA多种后处理技术对AOCA的 诊断及其异常走行的解剖形态显示有重要意义。

Objective To explore the application value of coronary computed tomography angiography (CCTA) in the diagnosis of anomalous origin of coronary artery (AOCA) and the evaluation of anatomical features. Methods The imaging data of CCTA successful performed in our hospital from January 2014 to December 2019 were analyzed. The anatomical structures such as AOCA and course of coronary artery were observed by using CT raw data combined with the techniques of post-processing software: maximum intensity projection, multiplanar reconstruction, curved surface reconstruction and volume rendering. Results Among 7235 cases of CCTA analyzed, 87 cases of AOCA were detected with a detection rate of 1.2%. Among the AOCA, the most common type of variation was originated from anomalous coronary sinus (34 cases), followed by high origin (30 cases) and absence of left main trunk (21 cases), and rare originated from pulmonary artery (1 case) and single coronary artery (1 case). 53 cases of AOCA were associated with high-risk anatomical structures, which were found in high origin and originating from anomalous coronary sinus respectively丨 the incidence of right coronary artery origin variation with high-risk anatomical structure was higher than that of left coronary artery origin variation, and the difference was statistically significant. Conclusion A variety of post-processing techniques of CCTA are of great significance for the diagnosis of AOCA and the display of anatomical morphology of abnormal coronary artery.