能谱和普通冠状动脉CTA检测心房颤动患者左心耳定量研究

A quantitative study on the left atrial appendage in patients with atrial fibrillation by pectral and common coronary CTA

目的探讨能谱和普通冠状动脉CT血管成像(CTA)扫描技术对心房颤动患者左心耳的定量研究价值。方法收集行冠状动脉CTA及经食管超声检查(TEE)心房颤动患者98例,根据CTA扫描仪器不同分为能谱组及普通组,另同期行CTA健康人群84例为对照组。测量和比较各组左心耳开口长径、短径、面积、左心耳嵴部嵴长和嵴上缘、中部、下缘宽度,以及左心耳开口与左上肺静脉距离。以TEE结果为“金标准”,通过Pearson相关性分析评估能谱和普通冠状动脉CTA测量准确性。结果心房颤动组左心耳开口长径、短径、面积大于对照组,左心耳嵴部嵴长、上缘宽、中部宽小于对照组(P<0.05)。能谱组和普通组各指标CTA测值与TEE测值比较,差异均无显著性(P>0.05)。能谱组和普通组各指标测值与TEE测值具有显著相关性,且能谱组相关性高于普通组。结论能谱冠状动脉CTA可较准确定量检测心房颤动患者左心耳解剖数据,可用于指导临床心房颤动患者手术方案的制定。

Aim To investigate the value of pectral and common coronary CTA in quantitative study of the left atrial appendage in patients with atrial fibrillation.Methods A total of 98 patients with atrial fibrillation who were underwent coronary CTA and transesophageal echocardiography(TEE)were collected.According to the differences of the scanning equipments of coronary CTA,they were divided into pectral group and common group,and 84 healthy people who received coronary CTA in our hospital during the same period were included as the control group.Left atrial appendage orifice long axis,short axis,area,the length of left atrial appendage ridge,the width of superior border,middlepart and inferior marginof left atrial appendage ridge,and the distance from left atrial appendage ostium to left superior pulmonary vein ostiumand were measuredand compared in each group.Using the result of TEE as the‘gold standard’,the accuracy of pectral and common coronary CTA to measure the above indicators were evaluated by Pearson correlation analysis.Results The long diameter,short diameter and area of the left atrial appendage(LAA)opening in AF group were larger than those in the control group,while the length of LAA crest,the width of upper edge and middle edge of LAA crest were smaller than those in the control group(P<0.05).There was no significant difference between the measured values of CTA and TEE in the energy spectrum group and the general group(P>0.05).The measured values of each index in the energy spectrum group and the general group were significantly correlated with the measured values of TEE,and the correlation in the energy spectrum group was higher than general group.Conclusion Pectral coronary CTA can accurately detect the left atrial appendage in patients with atrial fibrillation,which can be used to guide the formulation of surgical plan for patients with atrial fibrillation.