Objective To describe and classify the anatomic variations of pulmonary veins by multi-slice spiral CT (MSCT), so as to provide anatomic basis for radio-frequency ablation of atrial fibrillation and cardio-thoracic surgery. Methods Two hundred and fifty patients underwent coronary CT angiography with MSCT were respectively analyzed. The anatomical structure of pulmonary veins was observed by post-processing techniques such as multi-plane reconstruction (MPR), maximum density imaging (MIP) and volume reconstruction (VR). The frequency of each type was classified and counted. Results The incidence of common vein and accessory pulmonary veins was 38.8% and 15.2%, respectively, with no gender difference. The left atrium and pulmonary vein connection could be divided into 4 types: 130 cases in standard type (52%), 83 cases in common vein type, which was the most common variation type(33.2%), 23 cases in additional vein type ( 9.2%), and 14 cases in mixed type ( 5.6%). The variation rate of bilateral pulmonary vein drainage patterns was 54%, 26.8% on right side, 42% on left side, with no gender difference. Conclusions Pulmonary veins has great variability. MSCT can display pulmonary vein in detail, which is an effective tool to study its anatomical structure.
Key words
Pulmonary vein /
Left atrium /
Multi-slice spiral computed tomography /
Anatomy
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References
[1] Narasipuram A, Chandraputula M, Fatima H. Anatomic study of number of pulmonary veins draining into the left atrium and their variations[J]. Journal of Medical Sciences and Health, 2020,6(2):43-45. DOI: 10.46347/jmsh.2020.v06i02.008.
[2] Lawler LP, Fishman EK. Thoracic venous anatomy multidetector row CT evaluation[J]. Radiol Clin North Am, 2003,41(3):545-560. DOI: 10.1016/s0033-8389(03)00034-4.
[3] Kaur A, Sharma A, Sharma M. Variations in the number of pulmonary veins draining into left atrium and its clinical significance[J]. International Journal of Medical and Dental Sciences, 2017,6(1):1413-1416. DOI: 10.19056/ijmdsjssmes/2017/v6i1/125564.
[4] 何珍,万业达,齐扬,等. 肺静脉分型的多层螺旋CT解剖研究[J]. 实用放射学杂志, 2008,4(07):896-899. DOI: 10.3969/j.issn.1002-1671.2008.07.010.
[5] Pontone G, Andreini D, Bertella E, et al. Comparison of cardiac computed tomography versus cardiac magnetic resonance for characterization of left atrium anatomy before radiofrequency catheter ablation of atrial fibrillation[J]. Int J Cardiol, 2015,179:114-121. DOI: 10.1016/j.ijcard.2014.10.030.
[6] Altinkaynak D, Koktener A. Evaluation of pulmonary venous variations in a large cohort : Multidetector computed tomography study with new variations[J]. Wien Klin Wochenschr, 2019,131(19-20):475-484. DOI: 10.1007/s00508-019-1517-2.
[7] Schwartzman D, Lacomis J, Wigginton W G. Characterization of left atrium and distal pulmonary vein morphology using multidimensional computed tomography[J]. Journal of the American College of Cardiology, 2003,41(8):1349-1357. DOI: 10.1016/S0735-1097(03)00124-4.
[8] 王生元,曹成瑛,边慧平,等. 64排螺旋CT肺静脉-左心房连接解剖学分析[J]. 实用放射学杂志, 2012,28(4):530-532. DOI: 10.3969/j.issn.1002-1671.2012.04.011.
[9] Marom E M, Herndon J E, Kim Y H, et al. Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation.[J]. Radiology, 2004,230(3):824-829. DOI: 10.1148/radiol.2303030315.
[10]刘树伟. 断层解剖学[M]. 第3版. 北京:高等教育出版社, 2017:185-186.
[11]Cronin P, Kelly A M. Pulmonary venous abnormalities encountered on pre-radiofrequency ablation mapping multidetector computed tomography[J]. SA journal of radiology, 2017,21(1):1-11. DOI: 10.4102/sajr.v21i1.1189.
[12]虞康惠,江桂华,成官迅. 多层螺旋CT肺静脉成像在房颤射频消融术中的应用价值[J]. 中国医学物理学杂志, 2016,33(05):515-521. DOI: 10.3969/j.issn.1005-202X.2016.05.017.
[13]牟焕晨,吕仁杰,许传斌. 256层螺旋CT对肺静脉解剖的观察及临床应用[J]. 黑龙江医药科学, 2015,38(04):63-64. DOI: 10.3969/j.issn.1008-0104.2015.04.031.
[14]孟辉强,武志峰. 双源CT对心房颤动射频消融术前左心房及肺静脉的评估[J]. 中国药物与临床, 2017,17(01):55-57. DOI: 10.11655/zgywylc2017.01.020.
[15]季学兵,刘畅,魏建林,等. MSCT在房颤射频消融术前评价肺静脉的价值[J]. 中国CT和MRI杂志, 2014,12(03):41-44. DOI: 10.3969/j.issn.1672-5131.2014.03.12.
[16]李继承. 组织学与胚胎学[M]. 第9版. 北京:人民卫生出版社, 2018:248-249.
[17]史英红. 256层螺旋CT对左心房肺静脉解剖及成像质量辐射剂量的评价[D]. 山东大学, 2015:118.
[18]Wannasopha Y, Oilmungmool N, Euathrongchit J. Anatomical variations of pulmonary venous drainage in Thai people: multidetector CT study[J]. Biomed Imaging Interv J, 2012,8(1):e4. DOI: 10.2349/biij.8.1.e4.
[19]刘树伟,柳澄,王怀经,等. 右肺肺段和亚肺段支气管和血管的矢状断层解剖学研究[J]. 中国临床解剖学杂志, 2005，23(6):561-565.DOI: 10.13418/j.issn.1001-165X.2005.06.001.
[20]Reddy Y N V, El Sabbagh A, Packer D, et al. Evaluation of shortness of breath after atrial fibrillation ablation—Is there a stiff left atrium[J]. Heart Rhythm, 2018,15(6):930-935. DOI: 10.1016/j.hrthm.2018.01.029.
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