肺静脉变异的MSCT研究

Multi-slice spiral computed tomography study of pulmonary vein variation

目的:探讨MSCT对肺静脉与左心房连接方式各种变异的显示,为临床提供解剖学信息。方法:收集例行冠状动脉CTA检查且排除影响肺静脉疾病者共712例,其中男449例,女263例;年龄34～82岁,平均59.63岁。以原始横断面CT图像为基础,采用VR、MIP及MPR等后处理方法,观察并统计肺静脉开口数目、副肺静脉及肺静脉共同开口情况,进行分型,并对肺静脉共干、副肺静脉在性别及肺静脉变异左右侧别有无差异进行统计学分析。结果:肺静脉可分为4种类型,标准型最常见,共532例(74.7%);副肺静脉型85例(11.9%),其中左副肺静脉6例,右副肺静脉72例,最上肺静脉7例;肺静脉共同开口型86例(12.1%),其中左侧肺静脉共干76例,右侧肺静脉共干6例,双侧肺静脉共干4例;混合型9例(1.3%)。肺静脉的变异率为25.3%。副肺静脉发生率男性为14.3%,女性11.4%,肺静脉共干发生率男性14.0%,女性12.2%,以上性别差异无统计学意义。肺静脉变异率左侧13.3%(95/712),右侧12.8%(91/712),差异无统计学意义。结论:肺静脉的解剖变异较大,对肺静脉进行合理的分型,有助于肺静脉与左心房关系的解剖学评估,可为临床手术及房颤射频消融治疗提供有价值的肺静脉解剖路线图。

Objective：To study the various variations of connect between lung vein and left atrium by multi-slice spiral computed tomography（MSCT）,in order to provide accurate anatomic data for clinical application.Methods：712 routine patients underwent coronary CT angiography were collected,and excluded the diseases of affecting the lung vein,among which 449 were males and 263 were females.The average age was 59.63 years-old.All cases were based on CT axial images,used volume rendering（VR）,maximum intensity projection（MIP）and multiplanar reformation（MPR）and other post-processing methods,observed with the opening numbers of lung vein and the common opening appearance condition of associated lung vein and lung vein.Statistical analyzed the rate from all circumstances and divided type,and analyzed statistically the difference in sex of occurrences rate in the common pulmonary vein and additional pulmonary vein,and analyzed the statistically difference on the left and right of variations of lung vein.Results：The pulmonary veins could be divided into 4 types：standard type was the most common and account for 74.7%（532 cases）;additional pulmonary vein type was 11.9%（85 cases）,of which 6 cases were the left pulmonary vein,72 cases were the right pulmonary vein and 7 cases were the top pulmonary vein;The common pulmonary vein type was 12.1%（86 cases）,of which the left side was 76 cases and the right side 6 cases,bilateral were also 4 cases,mixed variation type was 1.3%（9 cases）.The variation rate of lung vein was 25.3%.The associate lung vein occurrence rate male was 14.2% and female 11.4%,the sexual discrepancy had no statistical significance,the occurrence rate of the common pulmonary vein male was 14.0% and female 12.2%.These sexual discrepancy had no statistical significance.There was no statistical discrepancy in variation rate of the lung vein left side was 15.9% and the right side was 13.6%.Conclusion：The anatomical variations of lung vein is common,to divide lung vein into various reasonable types through MSCT,that contributed to the assessment of pulmonary vein and left atrium.