64排螺旋CT心脏增强扫描在左心耳解剖形态评价中的应用  

The application of 6 4-slice spiral CT cardiac enhancement scanning in the morphological assessment of left atrial appendage

作　　者：杨延坤[1] 郑宏[1] 孙鑫[2] 徐争鸣[3] 杨新令[1] 吕滨[1] 

机构地区：[1]北京协和医学院阜外心血管病医院放射科,北京100037 [2]中国人民解放军空军航空医学研究所附属医院胸心外科 [3]中国人民解放军海军总医院心脏中心

出　　处：《实用放射学杂志》2014年第4期584-587,共4页Journal of Practical Radiology

摘　　要：目的：探讨64排螺旋CT心脏增强扫描在左心耳解剖形态评价中的应用价值。方法回顾性入选行冠状动脉增强扫描的窦性心律患者142例及消融手术前行肺静脉及左心房增强扫描的房颤患者25例,所有扫描图像行后处理并进行数据测量及左心耳解剖形态相关分型。结果入选患者167例,其中男88例,女79例,年龄（53.7＆#177;8.9）岁。左心耳口位置高于、平行于、低于左上肺静脉平面分别为4例（2.4%）,144例（86.2%）,19例（11.4%）。左心耳口形态分型：椭圆形（162例,97%）,类圆形（3例,1.8%）,水滴形（2例,1.2%）。左心耳形态分型：菜花型（35例,21%）,风向标型（41例,24.6%）,仙人掌型（7例,4.2%）,鸡翅型（84例,50.3%）。房颤患者较窦性心律患者具有更大的左心耳容积。结论64排螺旋CT心脏增强扫描可对左心耳及其相邻解剖结构提供形象、直观的解剖参考,并可对左心耳解剖参数进行定量评价,可能对左心耳封堵术具有较好的指导意义。Objective To explore the application value of 64-slice spiral CT cardiac enhancement scanning in the morphological as-sessment of left atrial appendage（LAA）.Methods Patients were selected retrospectively between April 16,2013 and May 1,2013, including 142 patients with sinus rhythms underwent MDCT coronary angiography,25 patients with atrial fibrillation underwent MDCT pulmonary vein-left atrial angiography.All images were post-processed,datas were measured and the morphology of left at-rial appendage were classified into different types.Results 167 patients were enrolled,including 88 males and 79 femals,age 53.7＆#177; 8.9 years.Anatomical relationship of the orifice of left atrial appendage to left superior pulmonary vein（LSPV）were classified as high type （superior to LSPV,2.4%）,middle type（parallel to LSPV,86.2%）,low type（inferior to LSPV,11.4%）.LAA orifice could be classified into three types including oval（162,97%）,round-like（3,1.8%）and drop-like（2,1.2%）.LAA morphology could be classified in four types including Cauliflower（35,21%）,Windsock（41,24.6%）,Cactus（7,4.2%）,Chicken-wing（84, 50.3%）.Patients with atrial fibrillation have a larger LAA volume than who with sinus rhythm.Conclusion 64-slice spiral CT car-diac enhancement scanning can provide a vivid and intuitive reference to the anatomy of LAA and its adjacent structures,and it can also provide quantitative evaluation of LAA anatomical parameters,so it may have a nice significance in the direction of LAA occlu-sion.

关 键 词：计算机体层成像 左心耳 解剖形态 左心耳封堵术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.1[医药卫生—放射医学]