多层螺旋CT对肺静脉口径测量及解剖变异研究

Ostium diameters of the pulmonary venous and variations in drainage to the left atrium with MSCT

目的本研究探讨多层螺旋CT(MSCT)肺静脉造影对正常肺静脉的影像学反映价值,为心血管介入治疗提供依据。方法随机选择无心脏及肺部疾病的正常成年人80例,通过MSCT肺静脉造影对左房及肺静脉进行三维重建及图像分析,测量肺静脉各支开口直径值,计算肺静脉开口直径均值,并对肺静脉各支开口数目进行评估。结果肺静脉各开口直径:左上肺静脉(LSPV,n1=77),平均口径值(19.00±5.58)mm;左下肺静脉(LIPV,n2=77),平均口径值(15.10±4.56)mm;右上肺静脉(RSPV,n3=64),平均口径值(18.06±5.80)mm;右下肺静脉(RIPV,n4=64),平均口径值(15.34±4.65)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。左、右肺静脉开口变异率分别为3.75%(3/80)、20.00%(16/80)。右肺静脉开口数目的变异率明显高于左肺静脉开口数目的变异率,(P<0.05)。结论通过MSCT肺静脉造影可对肺静脉各支的开口直径及数目进行较准确检测。MSCT肺静脉造影可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 measure the diameter of pulmonary venous（PV） and evaluate the various drainage patterns of the pulmonary veins as depicted with Multi-slice spiral computed tomography （MSCT）. We evaluate the clinical value of MSCT in implications for radiofrequency ablation. [Methods] A total of 80 patients without pulmonary and heart disease were eligible for inclusion. We measured the ostium diameter of the pulmonary veins and recorded the number of venous ostia with MSCT. [Results] The ostium diameters of the pulmonary veins are LSPV： （19.00±5.58） mm, LIPV （15.10±4.56） mm, RSPV： （18.06±5.80） mm, RIPV： （15.34 ±4.65） mm. The ostium diameter of superior pulmonary vein was significantly bigger than the inferior pulmonary vein at the same side （P 〈0.05）. Sixteen people （20%） had three to four ostia on the right side, which were due to one or two separate middle lobe vein ostia. Three people （3.75%） had a sing/e ostium on the left side. Right-sided venous drainage was more variable than left-sided venous drainage （P 〈0.05）. [Conclusions] MSCT is a evaluation method to succincdy describe pulmonary venous ostium diameters and drainage patterns before radiofrequency ablation.