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目的:环肺静脉线性前庭隔离术是近年来普遍采用的心房颤动(简称房颤)介入治疗技术,该技术要求术者对真实解剖结构的准确理解。64层螺旋CT(MSCT)左心房肺静脉成像可以提供详细的术前、术后解剖学信息,并对两侧前庭区进行观察与分析。本研究对二组大样本患者进行64层MSCT左心房肺静脉成像,获得前庭区形态学分析,用以指导房颤消融术并评估预后。方法:对232例患者(房颤组146例,对照组86例)行64层MSCT左心房肺静脉成像,显示双侧前庭区,进行解剖学分析,并比较房颤组及对照组前庭区的周长、面积及形态。结果:两组患者两侧前庭均为不规则状。房颤组前庭周长:左侧(119.61±24.71)mm,右侧(128.84±24.77)mm;对照组前庭周长:左侧(97.83±9.37)mm,右侧(107.56±4.79)mm;房颤组前庭面积:左侧(1053.79±561.57)mm2,右侧(1246.07±542.64)mm2;对照组前庭面积:左侧(621.13±89.80)mm2,右侧(849.20±59.03)mm2。结论:64层MSCT左心房肺静脉成像可以在环肺静脉线性前庭隔离术术前提供详细的肺静脉前庭区解剖数据,且在房颤组和对照组中存在明显差异。本研究所得出的各项形态学分析结果对介入治疗具有重要的指导意义。
OBJECTIVE: Central venous pulmonary vestibular varicose veins is a widely used interventional therapy for atrial fibrillation (AF) in recent years. This technique requires the surgeon to have an accurate understanding of the true anatomy. 64-slice spiral CT (MSCT) left atrium pulmonary venous imaging can provide detailed preoperative and postoperative anatomical information, and observe and analyze the vestibular region on both sides. In this study, we performed 64-slice MSCT left ventricular pulmonary venous imaging in two large groups of patients and obtained morphological analysis of the vestibular region to guide the ablation of atrial fibrillation and evaluate the prognosis. Methods: A total of 232 patients (146 in AF group and 86 in control group) underwent 64-slice MSCT of left atrium pulmonary veins. The bilateral vestibular areas were observed and analyzed. Length, area and shape. Results: The two groups of patients with both sides of the vestibular irregular shape. The mean length of vestibular space was (119.61 ± 24.71) mm on the left and 128.84 ± 24.77 mm on the right in the AF group. The mean length of the vestibular space in the control group was 97.83 ± 9.37 mm on the left and 107.56 ± 4.79 mm on the right The vestibular area in the tremor group was 1053.79 ± 561.57 mm2 on the left and 1246.07 ± 542.64 mm2 on the right. The vestibular area in the control group was 621.13 ± 89.80 mm2 on the left and 849.20 ± 59.03 mm2 on the right. CONCLUSIONS: 64-slice MSCT left atrium pulmonary venous imaging provides anatomic data of the vestibular area of the pulmonary veins before the circumferential pulmonary vestibulo-venous isolation and there is a clear difference between the AF group and the control group. The morphological analysis results obtained in this study have important guiding significance for interventional therapy.