16层螺旋CT血管成像评估心脏静脉系统

Noninvasive Evaluation of Cardiac Veins with 16-Slice Spiral CTA

目的:研究16层螺旋CT血管成像(CTA)评价心脏静脉的可行性及可靠性。方法:选择行冠状动脉CTA检查并经影像学和临床其他检查最终证实为无冠状动脉疾病及心肌病患者30例(男17例,女13例;年龄36～86岁)。将其冠状动脉CTA图像数据进行最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)和容积再现(VR)等图像后处理,采用血管分析软件测量冠状窦(CS)、心大静脉(GCV)、心中静脉(MCV)、左室后静脉(LPV)、侧静脉(LV)近端直径,心中静脉、后静脉及侧静脉从冠状窦口至心大静脉肉眼可辨别的最远端管腔中心线的长度,对冠状静脉血管图像质量进行评分(0～3分)。结果:心大静脉、心中静脉及左室后静脉及侧静脉近端的直径分别为(8.4±1.1)mm、(5.8±2.2)mm、(2.9±1.1)mm、(4.6±1.2)mm。冠状静脉窦口上下径为(14.4±3.5)mm,前后径为(8.7±2.2)mm。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,心小静脉显示率为13.3%(4/30)。结论:16层螺旋CT冠状动脉成像(CTA)在评价冠状动脉的同时可以评价心脏静脉系统,可以作为无创显示冠状静脉系统的一种较可靠的方法。

Objective To evaluate the feasibility and reliablity of visualizing cardiac veins with 16-Slice Spiral coronary angiography （CTA）. Methods 30 eases （male 17, female 13; 36 -86 years old） without coronary diseases received CTA were included in this study. The CTA data were postproeessed with MIP, MPR, CPR and VR reeoustruetion, and the diameter of the proximal segments of coronary sinus（CS）, vene eorclis magna（GCV）, vene eodis media （MCV）, left ventrieular posterior vein （LPV） and leteral vein （LV） was measured using vascular analysis software. The length of cardiac veins was also measured. The quality of the cardiac veins on spiral CT imaqing was graded using a 4-point scale for each cardiac vein （grade 0： not visable; grade 1： visable with diseontinuily; grade 3： visable as smoothly bordered vascular structure）. Results Diameters of proximal segments of GCV, MCV, LPV and LV were 8.4 ± 1. 1mm, 5.8± 2.2mm, 2.9 ± 1.1 mm, 4.6 ± 1.2mm, respectively. The superoinferior diameter of CS was 14.4 ±3.Snan, the anteroposterior diameter of CS was 8.7± 2.2mm. The CS, GCV and MCV were seen in all subjects. 2 -3 LPV were visualized in most subjects. Small cardiac vein was found in 13.3% （4/30）. Conclusions 16-slice spiral CT coronary angiography could noninvasively evaluate coronary artery and cardiac venous anatomy. It is a reliable method to noninvasively visualize cardiac venons anatomy.