CAJ | 학술논문

目的：利用CT三维成像技术研究心房颤动（房颤）患者行环肺静脉电隔离术前后肺静脉形态学的变化。方法2008年5月至-2011年7月对24例房颤患者行房颤环肺静脉电隔离术，用64排螺旋CT行心脏扫描。研究随访射频消融（RFA）术后3～6个月患者肺静脉的形态改变特点，并与术前进行对比。结果与术前相比，术后左上肺静脉口最大径、右下肺静脉口最小径、左上肺静脉口截面积差异无统计学意义（P>0.05），但其他肺静脉口参数最大径、最小径和截面积差异有统计学意义（P<0.05）。与术前相比，术后右下肺静脉圆度差异有统计学意义（P<0.05），而其他肺静脉口参数、肺静脉指数及圆度差异无统计学意义（P>0.05）。男女性别间肺静脉口参数差异无统计学意义（P>0.05）。24例患者中，右肺静脉开口3支变异达21%，左肺静脉开口3支变异达4%，右肺静脉多支变异达4%。结论房颤患者的肺静脉和左心房一样具有解剖重构，RFA后可逆转其重构。肺静脉开口变异中，右肺静脉开口变异较大。
목적：이용CT삼유성상기술연구심방전동（방전）환자행배폐정맥전격리술전후폐정맥형태학적변화。방법2008년5월지-2011년7월대24례방전환자행방전배폐정맥전격리술，용64배라선CT행심장소묘。연구수방사빈소융（RFA）술후3～6개월환자폐정맥적형태개변특점，병여술전진행대비。결과여술전상비，술후좌상폐정맥구최대경、우하폐정맥구최소경、좌상폐정맥구절면적차이무통계학의의（P>0.05），단기타폐정맥구삼수최대경、최소경화절면적차이유통계학의의（P<0.05）。여술전상비，술후우하폐정맥원도차이유통계학의의（P<0.05），이기타폐정맥구삼수、폐정맥지수급원도차이무통계학의의（P>0.05）。남녀성별간폐정맥구삼수차이무통계학의의（P>0.05）。24례환자중，우폐정맥개구3지변이체21%，좌폐정맥개구3지변이체4%，우폐정맥다지변이체4%。결론방전환자적폐정맥화좌심방일양구유해부중구，RFA후가역전기중구。폐정맥개구변이중，우폐정맥개구변이교대。
Objective To study the morphological changes of pulmonary vein after circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF) by using CT three-dimensional imaging technique. Methods During the period form May 2008 to July 2011 at authors’ hospital, CPVA was carried out in 24 patients with AF. 64-slice spiral CT scanning of the heart was performed. The changes of pulmonary vein morphology 3 - 6 months after CPVA were evaluated and were compared with the preoperative morphologic findings. Results After the treatment, the maximum diameter of the left upper pulmonary vein, the minimum diameter of the right lower pulmonary vein and the cross-section area of the left upper pulmonary vein showed no statistically significant changes when compared with those determined before CPVA (P >0.05). But statistically significant differences in the maximum diameter, the minimum diameter and the cross-section area of the other pulmonary veins existed between the preoperative data and postoperative ones (P <0.05). The roundness of the pulmonary vein mouth determined after CPVA was significantly different from the preoperative one (P<0.05). The differences in pulmonary vein mouth parameters, pulmonary vein index and the roundness of pulmonary vein mouth between preoperative and postoperative data were not significant (P >0.05). No significant difference in pulmonary vein mouth parameters existed between male and female patients (P > 0.05). Of the 24 patients, three branches variation of the right pulmonary vein was up to 21%, while three branches variation of the left pulmonary vein was 4%. Conclusion In patients with AF the pulmonary vein, being the same as the left atrium, has also anatomic reconstruction, which can be reversed after CPVA. In the variations of pulmonary vein mouth the variations of right pulmonary vein mouth is most commonly seen.(J Intervent Radiol, 2014, 23:288-291).