心房颤动导管消融术相关的左房-肺静脉邻近结构的解剖关系

Analysis of the structures adjacent to left atrium and pulmonary veins by computed tomography angiography in patients for catheter ablation of atrial fibrillation

目的应用CT扫描及三维重建的方法描述并测量心房颤动(简称房颤)患者左房-肺静脉与邻近解剖的关系。方法30例在三维标测技术下行环肺静脉左房线性消融术治疗的房颤患者,术前应用CT进行心脏扫描,二维平面测量肺动脉、上腔静脉、食管与左房-肺静脉的距离,三维重建后描述其解剖形态及与左房-肺静脉的位置关系。结果肺动脉与左房顶壁平均最小距离:3.95±3.33mm。上腔静脉与右上肺静脉平均最小距离:2.00±1.31mm,两者距离与右上肺静脉口二维平面径线及三维重建后静脉口最大径呈负相关。食管与左房后壁上缘、中部、下缘的距离分别为1.49±0.72,1.24±0.62,2.48±1.34mm。结论三维重建图像可真实反映左房-肺静脉与邻近结构的位置关系及距离。

Objective To characterize and measure the structures adjacent to left atrium （LA） and pulmonary veins （PVs） including pulmonary artery （PA） , superior vena cava（SVC） and esophagus （Es） by computed tomography （CT） angiography. Method Thirty patients with paroxysmaL/persistent atrial fibrillation （AF） undergoing computed tomography angiography before catheter ablation of AF were analyzed for the distance between the structures and LA-PVs. Resuits The average minimal distance between PA and superior wall of LA was 3.95 ± 3.33 mm and the average minimal distance between SVC and right superior pulmonary vein （RSPV） was 2.00 ±1.31 mm. The distance between Es and supe rior, medium and inferior part of posterior wall of LA were 1.49 ± 0.72, 1.24 ±.62 and 2.48 ±1.34 ram. Conclusion Three-dimensional reconstruction image can present precise anatomic relation between the adjacent structures and LAPVs.