64层螺旋CT在肺静脉解剖学研究中的应用

The application of 64-slice spiral CT in pulmonary venous anatomy research

目的:研究肺静脉开口大小、形状、第一分支距肺静脉开口距离及肺静脉主干大小和形状随走行的变化。方法:分析103例影像资料的肺静脉与左心房连接类型,测量肺静脉口及主干长短径、第一分支距肺静脉口距离,计算肺静脉口指数。结果:标准4支肺静脉81例(78.6%),上肺静脉口径大于下肺静脉,右上、下肺静脉口径分别大于左上、下肺静脉(P<0.05);右侧肺静脉口指数大于左侧;男性肺静脉口较女性大(P<0.05);男女肺静脉口指数差异无统计学意义。各支肺静脉第一分支距肺静脉口距离不同,左右、上下间具有显著差异(P<0.05);肺静脉口支出现率以右下最高(74.7%),左上最低(3.2%)。肺静脉主干汇入左房时部分(55.6%)左下肺静脉口径逐渐减小,其它3支逐渐增粗,形状都是逐渐变扁。结论:肺静脉解剖变异较大,各支肺静脉大小、形状及口支出现率不同,部分左下肺静脉汇入左房时其口径逐渐变小,在评价其狭窄时应特别注意。

Objective： To study the size and shape of pulmonary vein （PV） ostia, its distance to the first bifurcation, and the variation of PV trunk as it approaches the left atrium. Methods： The data of 103 patients were collected in this study. Pulmonary venous drainage patterns to the left atrium were analysed. The caliber of PV and distance to the first bifurcation were measured, and venous ostial index（VOI） were calculated. Results： Most patients（n=81, 78.6%） had four standard PVs. The caliber of superior PV ostia was larger than that of the inferior PV ostia. The right superior and inferior PV ostia were larger than the left PV ostia respectively （P〈0.05）. The VOI of the right was larger than that of the left. The caliber of PV in men was larger than that in women（P〈0.05）. The VOI between men and women was similar（P〉0.05）. The distance to the first bifurcation of each PV varied. They were different between the left and the right, the superior and the inferior PV （P〈0.05）. The PV ostial branches emergence rate of the right inferior PV（74.7%） was the highest and that of the left superior PV（3.2%） was the lowest. The caliber of some left inferior PV （55.6%） gradually decreased and the others increased as they entered the left atrium. All of the PV shapes gradually became oval. Conclusion： The PVs have a great anatomic variations. There is signifi- cant variability in PV caliber, shape and ostial branches emergence rate. Particular care must be taken when the left inferior PV is evaluated for its stenosis, as it usually narrows as it enters the left atrium.