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目的对肺静脉的变异和同侧肺静脉分支间的分型位置关系进行研究,指导房颤导管消融手术的准确定位。资料与方法选择478例行房颤消融术的患者,术前64排CT行心脏增强扫描,三维重组左心房和肺静脉,对肺静脉的数量、位置、分型和变异进行分析。结果肺静脉计数约80%为标准肺静脉,显著变异者约占0.6%,左肺静脉分支间关系位置分型中,倾斜型占84.3%,上下型和前后型分别占13.6%和1.5%;右肺静脉分支间关系位置分型中,倾斜型占90.8%,上下型和前后型分别占0.4%和8.2%。结论肺静脉分支间有典型的位置分型,少数患者肺静脉有显著变异,术前常规64排CT检查可显示变异和位置分型,对指导环肺静脉隔离手术具有重要意义。
Objective To study the relationship between the variation of pulmonary veins and the classification of ipsilateral pulmonary vein branches to guide the accurate location of catheter ablation in atrial fibrillation. Materials and Methods 478 patients undergoing atrial fibrillation ablation were retrospectively analyzed. The CT scan, 64-slice CT scan, three-dimensional reconstruction of left atrium and pulmonary vein were performed to analyze the number, location, classification and variation of pulmonary veins. RESULTS: Approximately 80% of pulmonary venous counts were standard pulmonary veins, with significant variations accounting for about 0.6%. In the classification of left pulmonary veins, 84.3% were inclined, 13.6% were upper and lower, and anterior and posterior were 1.5% In the relationship between the location type, tilt type accounted for 90.8%, up and down type and before and after the type accounted for 0.4% and 8.2%. Conclusion There are typical locations of pulmonary veins between different branches. A small number of patients have significant variations of pulmonary veins. Conventional 64 - slice CT examination can show the variation and location of the pulmonary veins, which is of great significance for guiding the isolation of pulmonary veins.