多层螺旋CT无创显示心脏冠状静脉系统

Noninvasive visualization of the cardiac venous system using multi-slice CT

目的 研究多层螺旋CT（MSCT）显示冠状静脉窦及其属支的CT解剖特征.方法 利用MSCT冠状动脉造影进行118例患者的冠状静脉成像,观测冠状静脉窦及其属支的形态、位置、数目、直径及角度. 结果 所有患者均可见冠状静脉窦、心大静脉及心中静脉,大多数患者可见2～3支左室后静脉,心小静脉及左房斜静脉显示率分别为11.0%（13/118）,7.6%（9/118）.心中静脉及左室后静脉多成直角汇入冠状静脉窦.心中静脉、心小静脉及左室后静脉的直径分别为（5.2±1.3） mm,（2.6±0.6） mm,（3.8±1.1） mm.冠状静脉窦口上下径为（13.8±4.1） mm,前后径为（10.4±2.9） mm.结论 MSCT可以作为无创显示冠状静脉窦及其属支的方法,可为心脏起搏器的置入提供有价值的信息.

Objective To depict the cardiac venous anatomic characteristics of the coronary sinus （CS） and its tributaries using multi-slice CT （MSCT）. Methods MSCT coronary artery angiography were used to exam the morphology, position, number, diameter and angulation of the CS and its tributaries in 118 patients. Results The CS, great cardiac vein and middie cardiac vein were seen in all patients. 2-3 left posterior vein （LPV） were visualized in almost patients. Small cardiac vein and Marshall vein were found in 11.0% （13/118） and 7.6% （9/118）, respectively. The middle cardiac vein （MCV） and left ventrieular posterior vein （LPV） drained the CS at an approximately 90° angle. The ostium of MCV, SCV and LPV were （5.2±1.3） mm, （2.6±0.6） mm, （3.8±1.1） mm, respectively. The diameter of the CS ostium was （13.8±4.1） mm in the superoinferior direction and （10.4±2.9） mm in the anteroposterior direction. Conclusion MSCT is a feasible and noninvasive method to visualize the CS and its main tributaries. It may help to decide whether transvenous left ventricle lead placement for cardiac resynchronization therapy is feasible.