双源CT心脏成像对正常成年人肺静脉和左心房的双时相评估价值

Biphasic evaluation of pulmonary vein and left atrium in normal adults by cardiac dual-source CT

目的利用双源CT心脏图像开展正常成年人肺静脉和左心房在心脏收缩期与舒张期双时相影像研究,为临床患者的评估提供参考。方法共纳入218例成人心脏双源CT扫描图像,且均有最佳收缩期和舒张期图像,于工作站使用图像三维重组技术进行分类和测量。记录肺静脉解剖变异情况、肺静脉孔径及左心房数据并统计分析。结果肺静脉变异中额外肺静脉易发生于右侧(左侧比例0.92%、右侧比例8.26%),而共干肺静脉则易发生于左侧(左侧比例13.3%、右侧比例0.92%)。左共类型最常见,右中类型次之,其他混合类型少见。肺静脉孔径测量时前后径小于上下径,上肺静脉孔径大于下肺静脉孔径,右肺静脉孔径较左肺静脉孔径大而圆,肺静脉孔径由大到小依次为右上、右下、左上、左下,右上肺静脉孔径最大最圆,左下肺静脉孔径最小最卵圆,额外肺静脉孔径较常规类型小,共干肺静脉孔径较常规类型大而卵圆。左心房横径最大,纵径次之,前后径最小。双期数据比较显示,收缩期肺静脉孔径较舒张期大而圆,收缩期左心房各径线均大于舒张期。结论肺静脉变异较为常见,肺静脉和左心房形态大小与心动周期相关,双源CT心脏成像可有效地显示及评估肺静脉和左心房的形态。

Objective To conduct dual phases radiologic-anatomic research of pulmonary vein and left atrium in normal adults using dual source CT cardiac images in order to provide reference information for the evaluation of clinical patients.Methods A total of 218 individuals who had underwent dual-source cardiac CT with best systolic and diastolic phase images were enrolled in the study.The three-dimensional reformation technique was used at the workstation to evaluate the anatomical variation of pulmonary veins,the morphology of pulmonary vein apertures and left atrium.All the data were recorded and analyzed statistically.Results In the pulmonary vein variations,the accessory pulmonary veins were more likely to occur on the right side(0.92%on the left side and 8.26%on the right side),and the common pulmonary veins were more likely to occur on the left side(13.3%on the left side and 0.92%on the right side).The left common type was the most frequently occurred variation followed by the right middle type and other mixed types were rare.In the pulmonary vein measurement,anterior-posterior diameter was smaller than superior-inferior diameter.The superior pulmonary vein apertures were larger than the inferior pulmonary vein apertures,and the right pulmonary vein apertures were larger and more round than the left pulmonary vein apertures.The order of the size of pulmonary vein apertures is the right superior pulmonary vein(RSPV),the right inferior pulmonary vein(RIPV),the left superior pulmonary vein(LSPV)and the left inferior pulmonary vein(LIPV)aperture from the largest to the smallest in turn.RSPV aperture was the largest and most round one while LIPV aperture was the smallest and most oval one.The accessory pulmonary vein aperture was smaller than that of the routine type,and the common pulmonary vein aperture was larger and more oval than that of the routine type.Left atrial anterior-posterior diameter was the smallest one,then the longitudinal and transversal diameter in turn.The comparison of the dual phases data showed that the pulmonary vein aperture in the systolic phase was larger and more round than that in the diastolic phase,and the left atrial diameter in the systolic phase was also larger than that in the diastolic phase.Conclusion Pulmonary vein variation was common.The size and morphology of pulmonary veins and left atrium were related to cardiac cycle,and dual source cardiac CT could display and evaluate the pulmonary vein and left atrium effectively.