Accessory left atrial diverticulae: contractile properties depicted with 64-slice cine-cardiac CT
Accessory left atrial diverticulae: contractile properties depicted with 64-slice cine-cardiac CT
复制标题
DOI：
10.1007/s10554-009-9511-9
复制
发表时间：
2010-02-01
影响因子：
2.1
通讯作者：
Dodd, Jonathan D.
中科院分区：
文献类型：
--
作者：
Killeen, Ronan P.;Ryan, Ronan;Dodd, Jonathan D.
采用多期心脏CT评估副左心耳（LAAs）的收缩力。我们回顾性分析了102例连续患者（63例男性，39例女性，平均年龄57岁）中使用多相心脏64层CT检查的副左心耳的存在、位置、大小和收缩特性。多平面重建用于在轴向倾斜、矢状倾斜和冠状倾斜平面中创建图像平面。对于所有的附件，每千日元10毫米，轴向和矢状径和附件体积的孔直径的一部分，记录在心房颤动和收缩。进行回归分析，以评估哪些影像学表现最能预测附件收缩性。23例（23%）患者显示了副左心耳，均沿左心房前壁沿着。轴向斜位（AOD）和矢状斜位（SOD）直径以及矢状斜位长度（SOL）的尺寸分别为6.3-19、3.4-20和5-21 mm。在心房收缩期，所有附件（每千日元10 mm的一部分）均显示出显著的收缩（最大直径减小为AOD [3.8 mm，27%]）。相关分析显示，AOD收缩与AOD（R = 0.57，P < 0.05）、SOD收缩与AOD、SOD与SOL（R = 0.6，P < 0.05）均呈显著相关。心房舒张期平均憩室体积为468.4 +/- A 493 mm（3），收缩期为171.2 +/- A 122 mm（3），表明平均体积变化为297.2 +/- A 390 mm（3），P < 0.0001。逐步多元回归分析显示SOL是附件收缩力的最强独立预测因子（R-2 = 0.86，P < 0.0001），其次是SOD（R-2 = 0.91，P < 0.0001）。辅助左心耳在心脏CT上显示出显著的收缩特性。应评价矢状高度或深度较大的辅助左心耳的收缩特性，如果存在，应在电生理研究期间检查异位活动。
To assess the contractility of accessory left atrial appendages (LAAs) using multiphasic cardiac CT. We retrospectively analyzed the presence, location, size and contractile properties of accessory LAAs using multiphasic cardiac 64-slice CT in 102 consecutive patients (63 males, 39 females, mean age 57). Multiplanar reformats were used to create image planes in axial oblique, sagittal oblique and coronal oblique planes. For all appendages with an orifice diameter a parts per thousand yen 10 mm, axial and sagittal diameters and appendage volumes were recorded in atrial diastole and systole. Regression analysis was performed to assess which imaging appearances best predicted accessory appendage contractility. Twenty-three (23%) patients demonstrated an accessory LAA, all identified along the anterior LA wall. Dimensions for axial oblique (AOD) and sagittal oblique (SOD) diameters and sagittal oblique length (SOL) were 6.3-19, 3.4-20 and 5-21 mm, respectively. All appendages (a parts per thousand yen10 mm) demonstrated significant contraction during atrial systole (greatest diameter reduction was AOD [3.8 mm, 27%]). Significant correlations were noted between AOD-contraction and AOD (R = 0.57, P < 0.05) and SOD-contraction and AOD, SOD and SOL (R = 0.6, P < 0.05). Mean diverticulum volume in atrial diastole was 468.4 +/- A 493 mm(3) and in systole was 171.2 +/- A 122 mm(3), indicating a mean change in volume of 297.2 +/- A 390 mm(3), P < 0.0001. Stepwise multiple regression analysis revealed SOL to be the strongest independent predictor of appendage contractility (R-2 = 0.86, P < 0.0001) followed by SOD (R-2 = 0.91, P < 0.0001). Accessory LAAs show significant contractile properties on cardiac CT. Those accessory LAAs with a large sagittal height or depth should be evaluated for contractile properties, and if present should be examined for ectopic activity during electrophysiological studies.