三维CT影像资料测量国人心尖区心肌变薄的解剖学验证

Anatomical validation of the left ventricular apical thinning in Chinese people measured by three-dimensional CT imaging

背景:在常规心脏三维CT成像检查中可见国人心脏心尖部心肌存在变薄的影像改变,但未见文献报道。认识该影像征象的相关解剖及影像特征,可为临床相关学科的应用及研究提供客观基础。目的:确定国人心尖区心肌最薄点的存在,测量其厚度及位置关系。方法:解剖学观察12个体外心脏标本并利用游标卡尺测量心尖部最薄点厚度及左室心肌最厚处的厚度。选取2009-01/12在厦门大学附属中山医院CT室进行检查的69例无明确心脏疾患患者的三维CT资料,利用三维成像技术显示心尖部结构。测量心尖最薄点、左室心肌最厚处的厚度及心尖最薄点至冠状动脉前降支的距离。结果与结论:解剖学观察显示体外心脏标本心尖部存在心肌变薄区,厚度为(1.74±0.32)mm,左室心肌最厚处为(13.07±1.48)mm;三维CT可清楚显示心尖部心肌最薄区,厚度为(1.27±0.31)mm,左室心肌最厚处为(12.02±1.66)mm;心尖部最薄点到左冠状动脉前降支的距离为(13.70±3.78)mm。统计结果显示解剖学心尖部最薄点厚度与三维CT测量值差异有显著性意义(P<0.05)。结果证实国人心尖区心肌变薄是一种正常解剖结构,标本解剖学及活体三维CT影像学均可清楚显示。

BACKGROUND： In the application of heart three-dimensional CT imaging, the imaging sign of left ventricular apical thinning is observed in Chinese people. There is no any report in domestic literatures. To understand the anatomical and imaging features of the left ventricular apical thinning provides the basis for clinical applications and researches. OBJECTIVE： To confirm the left ventricular apical thinning in Chinese people, and to measure its thickness and location. METHODS： A total of 12 heart specimens of cadavers were observed, and the thickness of the left ventricular apical thinning was measured, as well as the thickest myocardium. 3D CT data of 69 cases without heart diseases were collected from PACS of Zhongshan Hospital of Xiamen University, the left ventricular apical thinning was shown with the techniques of 3D imaging, and the left ventricular apical thinning was measured, as well as the thickest myocardium and the distance between the left ventricular apical thinning and the anterior descending branch of the left coronary artery. RESULTS AND CONCLUSION： The anatomical methods clearly showed the left ventricular apical thinning, with thickness of （1.74±0.32） mm. The thickest myocardium of left ventricle was （13.07±1.48） mm. 3D CT also showed clearly the left ventricular apical thinning, with thickness of （1.27±0.31） mm, and the thickest myocardium was （12.02±1.66） mm. The distance between the left ventricular apical thinning and the left ventricular was （13.70±3.78） mm. There was significant difference between the thickness of apical thin point and thickest myocardium of the left ventricle （P 0.05）. This study proves that there is left ventricular apical thinning, which is normal anatomy in Chinese people showed on both anatomy and 3D-CT.