双源计算机断层扫描评价卵圆孔未闭在心动周期中的动态特征

Dynamic Evaluation of Patent Foramen Ovale with Dual-source Computed Tomography During Cardiac Cycle

目的探讨卵圆孔未闭(PFO)在心动周期中的形态学、动态特征及其邻近异常结构。方法收集59例行心电门控双源计算机断层成像发现PFO的成年患者影像学资料,评价PFO及邻近解剖结构特征、心动周期对PFO显示的影响。解剖评价内容:PFO大小、卵圆窝大小、继发房间隔厚度及是否合并房间隔瘤。结果 PFO平均长度、宽度和高度分别为(9.5 ± 4.6)mm、(6.4 ± 4.0)mm和(2.1 ± 0.6)mm,卵圆窝大小为(17.1 ± 5.3) mm×(15.4 ± 4.2) mm,继发房间隔宽度为(6.5 ± 2.4)mm。6例患者(10.1%)合并房间隔瘤。在心动周期中,多数患者PFO最佳图像质量见于70% R-R间期。结论 PFO显示最佳时相为70% R-R间期,心电门控双源计算机断层成像可评价PFO的精确解剖及周围结构特征,为PFO封堵提供详细的术前解剖数据。

Objective The purpose of this study was to determine the morphological and dynamic features of patent foramen ovale(PFO) and its surrounding structures with dual-source computed tomography(DSCT) during cardiac cycle. Method Fifty-nine adult patients who underwent ECG-gated DSCT coronary angiography and were detected with PFO were enrolled. The length, mid-width and height of the PFO tunnel, size of fossae ovalis, and thickness of septum secundum at the mid-tunnel level were measured and associated atrial septal aneurysm(ASA) was evaluated. The impact of cardiac cycle on demonstrating PFO was also analyzed.Results The mean length, mid-width and height of PFO tunnel were (9.5 ± 4.6) mm,(6.4 ± 4.0) mm and (2.1 ± 0.6) mm, respectively. The size of fossae ovalis was (17.1 ± 5.3) mm×(15.4 ± 4.2) mm. The mean thickness of septum secundum was (6.5 ± 2.4) mm. ASA was present in 6 (10.1%) cases.Conclusion The optimal phase for evaluating PFO was 70% R-R interval. DSCT could provide anatomic details on size, morphologic features of PFO and its surrounding structures.