增强MR血管造影在导管射频消融术治疗房颤中的应用

Application of CE-MRA in radiofrequency catheter ablation of atrial fibrillation

目的:评价MRI,特别是增强MR血管造影检查(CE-MRA)在导管射频消融术治疗房颤中的临床应用价值。方法:收集23例(男16例,女7例,年龄38￣75岁,平均60.4岁)经导管射频消融术治疗的房颤病人的MR资料,进行回顾性分析,观察肺静脉及左心房的显示情况及肺静脉的变异程度。结果:所有MR影像资料均能清晰显示左心房及肺静脉,多数病人(19例,82%)属经典型(左心房两侧均有两个独立开口),4例(18%)病人有变异,其中3例(13%)左侧为共干(一个开口),1例(4%)左侧为三支肺静脉,3例左侧共干中1例右侧为三支肺静脉。CE-MRA序列显示肺静脉开口率(100%)要高于Double-IR序列(61.5%)和FIESTA序列(71.4%)。结论:在导管射频消融术治疗房颤中,MRI及CE-MRA是首选的影像学检查方法,可准确提供肺静脉解剖路线图和相关实用数据。

Objective： To evaluate the clinical application of MRI, particularly the contrast enhanced magnetic resonance angiography （CE-MRA） in the treatment of atrial fibrillation by radiofrequency catheter ablation. Methods： The MRI materials of 23 patients （16 men, 7 women; age from 38 to 75 years; mean age 60.4 years） with atrial fibrillation underwent radiofrequency ablation were analyzed retrospectively, The demonstration of pulmonary veins and left atrium, the variation degree of the pulmonary veins were depicted. Results, All MRI images can be used to demonstrate the left atrium and pulmonary veins clearly. The majority of patients（n=19, 82%） had two ostia on both sides of the left atrium（classical type）. Four patients（18%） had variations of pulmonary veins. Among them 3（13%） had one common ostium on the left side of the left atrium. One（4%） had three veins on the left side. Of the 3 patients with a common ostium on the left side, 1 patient had three veins on the right side. The demonstration rate of pulmonary ostium by CE-MRA （100%） is higher than that of Double-IR （61.5%） and FIESTA（71.4%）. Conclusion： MRI and CE-MRA is the most useful imaging modality to demonstrate the pulmonary veins. It 6an provide a valuable road map and precise data of pulmonary veins in the treatment of atrial fibrillation by radiofrequency catheter ablation.