摘要
目的探讨冠状窦．左心房肌连接的双源CT冠状动脉成像（DSCTCA）形态特征，并评价冠状窦的功能和解剖特点。方法分析144例受检者（对照组96例，房颤组48例）的DSCTCA影像，通过测量收缩期、舒张期冠状窦横截面积的改变，间接评价冠状窦-右心房肌连接的存在，对冠状窦．左心房肌连接的数量、位置、长度及其与冠状窦形态特点的关系进行研究。连续变量使用t检验，类别变量采用联表的χ^2检验。结果（1）冠状窦与二尖瓣环呈平直、轻度弯曲、高位在对照组分别为62、16、18例，在房颤组分别为10、8、30例，2组比较差异无统计学意义（χ^2=0．093，P=0．954）。（2）对照组、房颤组冠状窦长度分别为（34．1±9．1）mm、（33．8±8．9）mm，2组比较差异无统计学意义（t=-0．486，P=0．628）。（3）131例（91．0％）可见冠状窦．左心房肌连接，单连接103例，长度为（22．6±12．7）mm，到冠状窦口的距离为（6．3±5．8）mm；双连接28例，近端连接长度为（11．1±3．6）mm，到冠状窦口的距离为（2．1±1．9）mm，远端连接长度为（13．2±6．2）mm，到冠状窦口的距离为（16．7±6．8）mm。对照组、房颤组冠状窦-左心房肌连接的数量、长度差异无统计学意义（P〉0．05）。（4）对照组冠状窦从心房舒张期到收缩期，横截面积缩窄约22．4％（44．5／198．8；t=-21．076，P〈0．01），而房颤组冠状窦从心房舒张期到心房收缩期未见明显收缩（t=0．374，P〉0．05）；舒张期房颤组冠状窦横截面积[（230．4±77．0）mm。]明显大于对照组[（198．8±65．4）mm。；t=-2．579，P〈0．05]。对照组9例未显示冠状窦-左心房肌连接患者，均于心房收缩期显示冠状窦收缩，提示冠状窦-左心房肌连接不是冠状窦收缩的主要原因。结论DSCTCA能清楚显示冠状窦解剖特点，可以了解冠状窦．左心房肌连接的长度、数量和位置。
Objective To investigate the morphologic features of coronary sinus （CS）-left atrium muscle connections, and evaluate the function and anatomical features of coronary sinus on dual-source CT coronary angiography （DSCTCA）. Methods Images of DSCTCA of 144 patients [ control group consisted of 96 patients, and atrial fibrillation （AF） group consisted of 48 patients ] were reviewed. The existence of coronary sinus-right atrium muscle connections was indirectly evaluated by measuring the cross-sectional area changes of the CS during atrial systole and atrial diastolic. The number, location, length of the CS-left atrium muscle connections and the relationship between CS-left atrium muscle connections and CS morphological characteristics were studied. The t test for continuous variables and Chi-square test for categorical variables were used in statistical analysis. Results （ 1 ） The anatomic course of the CS in relation to the mitral ring was straight, mild curvature and high riding of 62,16 and 18 cases in control group and 10, 8 and 30 cases in AF group, respectively. There was not statistical significance between the 2 group （χ2 = 0. 093, P = 0. 954）. （ 2 ） The CS length was （ 34. 1 ± 9. 1 ）, （ 33.8 ± 8.9 ） mm in Control group and AF group, respectively. There was no statistical significance between the 2 group （ t = - 0. 486, P = 0. 628 ）. （3） Coronary sinus-left atrium muscle connections were seen in 131 of the 144 patients （91.0%）. A single connection was seen in 103 of the 144 patients, with a mean length of （22. 6 ± 12. 7 ）mm within （6. 3 ± 5.8 ） mm of the coronary sinus ostium. 28 patients had two connections ; distal connections measured （ 13.2 ± 6.2）mm in length within （16.7 ± 6. 8） mm of the coronary sinus ostium, and proximal connections measured （ 11.1 ± 3.6） mm in length within （2. 1 ± 1.9 ） mm of the coronary sinus ostium. And there was no statistical difference the number and length of CS-left atrium connections in between Control group and AF group （P 〉0. 05）. （4） The CS narrowed 22. 4% （44. 5/198.8）in cross-sectional area from atrial diastolic to atrial systole in control group （t = - 21. 076, P 〈 0. 01 ）, while the CS had no obvious contraction in AF group（t = 0. 374 ,P 〉 0. 05 ）. The cross-sectional area of the coronary sinus during diastole was obviously larger in the AF group than in the control group[（230.4 ± 77.0） mm2 vs （198.8 ± 65.4） mm2, respectively, t = - 2. 579,P = 0. 01 ]. In control group （ n = 9 ） , the coronary sinus-left atrium connection was not seen, however, all showed a CS constriction during atrial systole, indicating that coronary sinus-left atrium muscle continuity is not likely the primary cause for coronary sinus contractions. Conclusions DSCTCA can clearly show the anatomical characteristics of CS, it can help to understand the length, number and location of the CS-left atrium muscle connection.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第10期890-895,共6页
Chinese Journal of Radiology
基金
基金项目：四川省卫生厅科技基金资助（090501）
