MSCT对一种少见变异型心房间通道的影像诊断及鉴别诊断价值

Imaging diagnosis and differential diagnosis of a rare variants of interatrial communications by MSCT

目的分析MSCT对一种少见变异型心房间通道的影像学诊断价值。方法选取在我院行冠状动脉、大血管或先心CTA增强检查中偶然发现的一种少见变异型心房间通道患者14例。对所有患者原始数据利用多平面重建、最大密度投影、3D容积展现等重建技术对图像进行分析;包括通道形态、起源、走行、终止部位、长度及宽度;根据通道形态及长度将其分成3种类型:漏斗型,长管型(长度≥20 mm),短管型(长度<20 mm)。结果14例变异的心房间通道,漏斗型3例(21.43%),长管型4例(28.57%),短管型7例(50.00%);14例变异型心房间通道均起自左心房顶上壁;11例(78.57%)汇入上腔静脉入右心房口处;3例(21.43%)汇入右心房;通道平均长度约(21.36±11.35)mm;宽度约(2.30±0.67)mm;其中6例(42.86%)合并心血管畸形,包括右冠状动脉起自左冠状窦,左心房异常隔膜,室间隔膜部瘤及冠状静脉窦闭锁各1例(7.14%);左心房憩室2例(14.29%)。结论MSCT能清晰显示心房间通道形态、起源、走行、终止点位置,对该少见变异型心房间通道的影像诊断及鉴别诊断具有重要价值。

Objective To analyze the imaging diagnostic value of MSCT for a rare variants of interatrial communications.Methods A total of 13 patients with a rare variants of interatrial communications were retrospectively collected.The original Data of all patients were analyzed by using multi-plane reconstruction,maximum density projection,3D-volume rendering tech‐nique.It mainly included channel shape,origin,passway,terminating point position,length and width.According to the chan‐nel shape and length,it can be divided into three types:funnel-shaped,long tubular type(length≥20 mm),and short tubular type(length<20 mm).Results Among the 14 cases,3(21.43%)cases were funnel-shaped,4(28.57%)cases were long tubu‐lar type,and 7(50.00%)cases were short tubular type.All 14 cases of variant interatrial channels originated from the upper wall of the left roof;11(78.5%)cases flowed into the superior vena cava draining into the right atrial orifice,and 3(21.43%)cases flowed into the right atrium.The average length of the channel was about(21.36±11.35)mm,and the width was about(2.0±0.67)mm;six(42.86%)of these cases were associated with cardiovascular malformations,including one(7.14%)each of right coronary artery arising from the left coronary sinus,left atrial anomalous fibromuscular cord,membraneous ventricular septal an‐eurysm and coronary sinus ostial atresia;and there was two(14.29%)cases of left atrial diverticulum.Conclusion MSCT can clearly show the morphology,origin,passway and terminating point of a rare variants of interatrial communications,which is of great value in the imaging diagnosis and differential diagnosis of a rare variants of interatrial communications.