Visualization of the cardiac venous system using cardiac magnetic resonance
Visualization of the cardiac venous system using cardiac magnetic resonance
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DOI：
10.1016/j.amjcard.2007.08.049
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发表时间：
2008-02-01
影响因子：
2.8
通讯作者：
Nagel, Eike
中科院分区：
文献类型：
--
作者：
Chiribiri, Amedeo;Kelle, Sebastian;Nagel, Eike
我们试图探讨心脏磁共振在显示心脏静脉解剖方面的价值。对于心脏再同步化治疗，通常通过经静脉途径将左心室导联放置到冠状静脉窦(CS)的一个支流中。了解心脏静脉系统的解剖和变异可能有助于左心室导联的定位。对23例受试者(16例志愿者和7例患者)的心脏磁共振检查进行了回顾性分析。所有检查均在血管内注射造影剂(志愿者使用Gadofosveset；患者使用Ga-Domer-17)后使用导航全心稳态自由进动冠状动脉成像进行。所有受试者的心脏静脉系统均可见。最常见的解剖变异(在12名受试者中为52%)是心脏小静脉与心脏交叉处CS的连接。10例(44%)小静脉独立于冠状静脉进入右心房，后室间静脉在心绞处与冠状静脉相连。仅1例CS与独立进入右心房的室间后静脉分离。左心室后静脉和左缘静脉距CS口的平均距离分别为15.2±4.7 mm和49.7±14.1 mm。总之，心脏静脉系统的解剖及其变异可以用心脏磁共振来描述。其植入前的可视化可能有助于简化种植过程和减少透视时间。(C)2008 Elsevier Inc.保留所有权利。
We sought to investigate the value of cardiac magnetic resonance to depict cardiac venous anatomy. For cardiac resynchronization therapy the lead for the left ventricle is usually placed by transvenous approach into a tributary of the coronary sinus (CS). Knowledge of the anatomy and variations of the cardiac venous system may facilitate the positioning of the left ventricle lead. The cardiac magnetic resonance examinations of 23 subjects (16 volunteers and 7 patients) were retrospectively analyzed. All examinations were performed using navigator-gated whole-heart steady-state free precession coronary artery imaging after administration of intravascular contrast agents (gadofosveset in volunteers; Ga-domer-17 in patients). The cardiac venous system was visualized in all subjects. The most frequent anatomical variant observed (in 12 subjects [52%]) was a connection of the small cardiac vein to the CS at the crux cordis. In 10 subjects (44%) the small veins entered the right atrium independently from the CS, and the posterior interventricular vein was connected to the CS at the crux cordis. Only one subject had a disconnection between the CS and posterior interventricular vein, which entered into the right atrium independently. The mean distance of the posterior vein of the left ventricle and the left marginal vein to the ostium of the CS was 15.2 +/- 4.7 mm and 49.7 +/- 14.1 mm, respectively. In conclusion, the anatomy of the cardiac venous system and its anatomical variability can be described using cardiac magnetic resonance. Its preimplantation visualization may help to facilitate the implant procedure and to reduce fluoroscopy time. (c) 2008 Elsevier Inc. All rights reserved.