摘要
目的 评价多层螺旋CT三维心脏重建技术在诊断阵发性心房颤动导管射频消融术电隔离大静脉肌袖后肺静脉狭窄的作用。方法 顽固性阵发性心房颤动患者 ,在环状标测电极指导下行大静脉肌袖的导管射频消融电隔离治疗 ,3个月后进行多层螺旋CT检查 ,容积重建心房及其肺静脉 ,并与电隔离术前的造影资料对照 ,分析肺静脉狭窄的发生率和程度 (轻度狭窄为 <5 0 % ,中度狭窄为 5 0 %～ 75 % ,重度狭窄为 >75 % ,完全闭塞为 10 0 % )。结果 30例患者共接受大静脉电隔离治疗38次 ,共隔离大静脉肌袖 89支 ,其中肺静脉 80支 ,上腔静脉 9支。多层螺旋CT均可成功重建出左房后壁以及各肺静脉 ,共发现肺静脉狭窄 10支 (12 5 % ) ,其中轻度狭窄 7支 ,重度狭窄 2支 (均为 2次消融 ) ,左上肺静脉完全闭塞 1支。有 9例无任何临床症状 ,平均随访 (8 3± 5 7)个月。结论应用多层螺旋CT造影增强后 ,可以清楚显示各肺静脉的开口直径及其分支 ,是评价和诊断肺静脉狭窄及其严重程度的重要无创检查方法。重复消融患者容易发生肺静脉的严重狭窄 。
Objective To investigate the feasibility of the visualization of pulmonary veins (PV) using multislice spiral computed tomography (MSCT) and the diagnostic value for pulmonary vein stenosis after radiofrequency(RF) ablation in patient with paroxysmal atrial fibrillation (PAF). Methods Patients with atrial fibrillation who received RF ablation of pulmonary veins were examined. A 16 slice spiral CT scanner was used to assess the pulmonary veins. Severity in stenosis was determined on a semi quantitative scale (<50%,50%-75%, >75% and 100%). Results Thirty patients underwent radiofrequency catheter ablation for PAF with total 89 veins including 9 superior vena cava electrically isolated from the atria. CT was performed without any complications in all patients. A detectable PV stenosis was observed in 12 5% (10/80) of veins. The severity of stenosis included occlusion in 1 vein(1 3%), severe in 2 veins(2 5%) ,and mild in 7 veins. All patients were asymptomatic, and none required treatment during the follow up period [mean(8 3±5 7) months]. Conclusions MSCT of the pulmonary veins is able to visualize clearly the PV stenosis and evaluate its severity after PV isolation. A more cautious approach may be required for patients undergoing repeat PV isolation.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2004年第3期217-220,共4页
Chinese Journal of Cardiology
基金
国家自然科学基金资助项目 ( 3 0 2 70 5 5 2 )
