摘要目的：评估多层螺旋CT在房颤导管射频消融术前的应用价值。方法：收集52例[男27例，女25例，平均年龄（68±11）岁]经导管射频消融术治疗的房颤病人的术前多层螺旋CT资料，进行回顾性分析，观察肺静脉的变异程度、开口形状及开口直径。结果：39例（75%）左心房右侧有两个开口，9例（17%）右侧有3~4个开口（由于有右中叶肺静脉）。4例（8%）右侧有一个开口（共干）。44例（85%）左心房左侧有两个开口，8例（15%）有一个开口（共干）。各肺静脉开口平均直径不同：右上肺静脉（12.5±2.4）mm；左上肺静脉（11.6±2.1）mm；右下肺静脉（13.2±2.0）mm；左下肺静脉（10.6±2.1）mm。左下肺静脉在汇入左房时通常变细。右侧肺静脉开口比左侧圆（肺静脉开口指数0.89±0.20 vs 0.74±0.16，P<0.05）。结论：多层螺旋CT可在导管射频消融术治疗房颤前提供有价值的肺静脉解剖路线图。肺静脉的引流方式、开口形状和直径存在不同。
Abstract：Objective: To evaluate the role of multi-detector row computed tomography(MDCT) in the treatment of atrial fibrillation by radiofrequency catheter ablation. Methods: The MDCT materials of 52 patients[27 men, 25 women; mean age, (68±11)years] with atrial fibrillation underwent radiofrequency ablation were analyzed retrospectively. MDCT was done before radiofrequency catheter ablation surgery. The variation of the pulmonary veins, the shape and the diameter of the ostia of the pulmonary veins were depicted and calculated. Results: Thirty-nine(75%) had two ostia on the right side. Nine(17%) had three to four ostia on the right side due to separate middle lobe vein. Four(8%) had a single ostium(common ostia). Forty-two(80%) had two ostia on the left side. Eight(15%) had a single ostium(common ostia). Mean pulmonary vein diameters at the ostia were variable: right superior, (12.5±2.4)mm; left superior，(11.6±2.1)mm; right inferior, (13.2±2.0)mm; left inferior, (10.6±2.1)mm. Caliber of the left inferior pulmonary vein decreased as it entered the left atrium. Ostia of the right pulmonary veins were more round than were ostia of the left pulmonary veins(pulmonary vein ostium index, 0.89±0.20 vs 0.74±0.16, P<0.05). Conclusion: Multi-detector row CT provides a valuable road map for pulmonary vein anatomy prior to radiofrequency catheter ablation. Pulmonary venous drainage pattern, shape and diameter vary.
2008, Vol. 19 
