64层螺旋CT观察肺静脉前庭区的初步研究

An initial study of anatomic and morphological analysis of pulmonary veins antrum with 64 multislice computed tomography

目的:环肺静脉线性前庭隔离术是近年来普遍采用的心房颤动(简称房颤)介入治疗技术,该技术要求术者对真实解剖结构的准确理解。64层螺旋CT(MSCT)左心房肺静脉成像可以提供详细的术前、术后解剖学信息,并对两侧前庭区进行观察与分析。本研究对二组大样本患者进行64层MSCT左心房肺静脉成像,获得前庭区形态学分析,用以指导房颤消融术并评估预后。方法:对232例患者(房颤组146例,对照组86例)行64层MSCT左心房肺静脉成像,显示双侧前庭区,进行解剖学分析,并比较房颤组及对照组前庭区的周长、面积及形态。结果:两组患者两侧前庭均为不规则状。房颤组前庭周长:左侧(119.61±24.71)mm,右侧(128.84±24.77)mm;对照组前庭周长:左侧(97.83±9.37)mm,右侧(107.56±4.79)mm;房颤组前庭面积:左侧(1053.79±561.57)mm2,右侧(1246.07±542.64)mm2;对照组前庭面积:左侧(621.13±89.80)mm2,右侧(849.20±59.03)mm2。结论:64层MSCT左心房肺静脉成像可以在环肺静脉线性前庭隔离术术前提供详细的肺静脉前庭区解剖数据,且在房颤组和对照组中存在明显差异。本研究所得出的各项形态学分析结果对介入治疗具有重要的指导意义。

Objective：Circumferential pulmonary vein antrum isolation has been evolved as a new treatment for patient with atrial fibrillation（AF）.The important of anatomy to the success of this technique is new appreciated.A detailed preoperative and postoperative anatomic information can be acquired by the 64 multislice spiral CT（MSCT） examination of left atrium and pulmonary veins,including the observation and analysis of bilateral pulmonary veins antrum.In this study,two groups of patients of a large sample received 64 MSCT examination of the left atrium and pulmonary veins,and we can acquire the morphological analysis of the pulmonary vein antrum to guide the atrial fibrillation ablation and to assess the prognosis.Methods：We analyzed the bilateral pulmonary vein antrum anatomy in 232 patients（146 cases in atrial fibrillation group and 86 cases in control group） by use of 64 multislice spiral computed tomography（64 MSCT）.The perimeter,area and shape of pulmonary veins antrum were compared between AF group and control group.Results：The shapes of bilateral pulmonary veins antrum were irregular in two groups of patients.Vestibular perimeter in atrial fibrillation group： left（119.61±24.71） mm,right（128.84±24.77） mm;Vestibular perimeter in control group： left（97.83±9.37） mm,right（107.56±4.79） mm;respectively;Vestibular area in atrial fibrillation group： left（1053.79±561.57） mm2,right（1246.07±542.64） mm2;Vestibular area in control group： left（621.13±89.80） mm2,right（849.20±59.03） mm2.Conclusion：64 MSCT of left atrium and pulmonary vein is an effecient way of showing pulmonary vein antrum anatomy prior to circumferential pulmonary vein antrum isolation.There is highly variant anatomy between AF group and control group.Various morphological findings acquired from this study are important infomation for interventional therapy.