DSCT肺静脉成像在房颤射频消融术前的临床应用价值  

Clinical application value of the pulmonary vein imaging by DSCT before radiofrequency catheter ablation of atrial fibrillation

作　　者：牛家成[1] 王昌华[1] 赵昕[1] 李平[1] 闫晴晴[1] 

机构地区：[1]山东省滕州市中心人民医院CT-MRI室,山东滕州277500

出　　处：《中国中西医结合影像学杂志》2015年第2期148-151,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的 ：综合应用双源Flash CT多种后处理方式,显示肺静脉解剖结构及其变异类型,描述并测量肺静脉口的解剖形态,为临床提供准确的肺静脉解剖学信息,指导房颤导管消融手术定位。方法：将临床诊断为房颤的100例患者作为研究对象（阵发性房颤组83例、持续性房颤组17例）,通过DSCT肺静脉成像对左房及肺静脉行三维重建及图像分析,评价肺静脉解剖及其变异情况、肺静脉各支口径大小。结果：肺静脉开口数目有2～6个不等,肺静脉总变异率为39%（39/100）,肺静脉变异的发生率左、右肺静脉差异无统计学意义。肺静脉各开口最大径及最小径分别为：左上肺静脉,最大径（20.37±2.91）mm、最小径（15.71±1.19）mm;左下肺静脉,最大径（16.25±1.57）mm、最小径（11.45±1.62）mm;右上肺静脉,最大径（22.15±2.19）mm、最小径（18.87±2.04）mm;右下肺静脉,最大径（18.81±2.12）mm、最小径（15.25±1.25）mm。同侧上肺静脉开口直径均值均大于下肺静脉（P〈0.05）,差异有统计学意义。结论 ：通过DSCT肺静脉成像可对肺静脉各支的口径及数目进行准确评价,能够作为房颤射频消融肺静脉电隔离术前的常规影像学检查手段。Objective：To evaluate morphologic characteristics of pulmonary vein on patient with atrial fibrillation by using multiplanar reconstruction techniques of multislice spiral computed tomography（DSCT）. Methods：100 patients with atrial fibrillation confirmed clinically（paroxysmal atrial fibrillation group 83 cases,17 cases of persistent AF group） were scanned by DSCT and then the 3D reconstruction images were taken and analyzed. Anatomical variations and orifice diameter of pulmonary veins were recorded. Results：The values of pulmonary vein openings maximum diameter and minimum diameter were ：left superior pulmonary vein,the maximum diameter（20.37±2.91） mm,most trails（15.71±1.19） mm; left pulmonary vein,the maximum diameter（16.25±1.57） mm,most trails（11.45±1.62） mm;right superior pulmonary vein,the maximum diameter（22.15±2.19） mm,most trails（18.87 ±2.04） mm;right pulmonary vein,the maximum diameter（18.81 ±2.12） mm,most trails（15.25 ±1.25） mm.Diameters of ipsilateral upper pulmonary vein were larger than inferior pulmonary vein（P 〈0.05）. In addition,the number of pulmonary vein openings varied ranging from 2 to 6. The pulmonary veins of the total variance were 39%（39/100）,There were no statistical difference of pulmonary vein variation in left/right side. Conclusion：DSCT which can accurately reveal anatomical characteristics of pulmonary vein can be used as routine preoperative examination for radiofrequency ablation of atrial fibrilla-tion.

关 键 词：心房颤动 肺静脉 解剖学 体层摄影术 X线计算机 

分 类 号：R541.75[医药卫生—心血管疾病]