肺静脉数量、变异和位置分型:478例64排心脏CT研究

The Anatomic Variation and Classification of Pulmonary Veins Using 64-slice Cardiac CT:A Report of 478 Cases

目的对肺静脉的变异和同侧肺静脉分支间的分型位置关系进行研究,指导房颤导管消融手术的准确定位。资料与方法选择478例行房颤消融术的患者,术前64排CT行心脏增强扫描,三维重组左心房和肺静脉,对肺静脉的数量、位置、分型和变异进行分析。结果肺静脉计数约80%为标准肺静脉,显著变异者约占0.6%,左肺静脉分支间关系位置分型中,倾斜型占84.3%,上下型和前后型分别占13.6%和1.5%;右肺静脉分支间关系位置分型中,倾斜型占90.8%,上下型和前后型分别占0.4%和8.2%。结论肺静脉分支间有典型的位置分型,少数患者肺静脉有显著变异,术前常规64排CT检查可显示变异和位置分型,对指导环肺静脉隔离手术具有重要意义。

Objective To study the anatomic variation of pulmonary vein（PV） and the anatomic classification of the ipsi-lateral PVs for guiding catheter ablation of atrial fibrillation（Af）.Materials and Methods Contrast enhanced cardiac 64 slice computed tomography（CT） was routinely performed in 478 cases of patients with Af who were planned to undergo ablation.Three dimensional images of left atrium and PV were segmented by volume rendered method.The numbers,position,classification,and variation of PVs were analyzed.Results In 80% of the patients,the number of PVs is standard and obvious variation was seen in about 0.6% of the patients.As to the anatomic relationship of left PVs,oblique,superior-inferior and anterior-posterior type accounted for 84.3%,13.6%,and 1.5%,respectively.As to the anatomic relationship of right PVs,oblique,superior-inferior and anterior-posterior type accounted for 90.8%,0.4%,and 8.2%,respectively.Conclusion Contrast enhanced cardiac 64 slice computed tomography（CT） reveal the apparent variation and the anatomic classification of the ipsi-lateral PVs,which can guide circumferential isolation of PVs in patients with Af.