Late gadolinium enhancement of the esophagus is common on cardiac MR several months after pulmonary vein isolation: preliminary observations.
Late gadolinium enhancement of the esophagus is common on cardiac MR several months after pulmonary vein isolation: preliminary observations.
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肺静脉隔离几个月后，食管的晚期钆增强在心脏 MR 中很常见：初步观察。
DOI：
10.1111/j.1540-8159.2009.02671.x
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Manning,WarrenJ
中科院分区：
文献类型：
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作者：
Meng,Joyce;Peters,DanaC;Hsing,JeffreyM;Chuang,MichaelL;Chan,Jonathan;Fish,Airley;Josephson,MarkE;Manning,WarrenJ
背景：肺静脉隔离（PVI）作为房颤（AF）的一种常用治疗方法。这个手术会损伤食道。晚期钆增强（LGE）心血管磁共振成像（CMR）提供无创评估疤痕。我们试图检查在PVI之前和之后LGE - CMR食管高强化的患病率。方法：74例AF患者在PVI前和PVI后1.7±1.9个月接受LGE - CMR检查。测量PVI前后相对于椎体的食道位置。结果：在PVI之前，3%（2/74）的患者在CMR上出现食管LGE。在PVI后随访中，30%（23/74）的研究显示消融部位附近出现新的食管高强化。大多数（74%,17/27）食管LGE阳性研究是在PVI后30天进行的，而在PVI后2个月进行的>研究中，没有（0/9）食管高强化阳性。帖子必经程序的存在食管hyperenhancement消融较长的时间无关(P = 0.42),使用一个灌溉导管(74% LGE vs 47%, P = 0.16),优先支持食管位置(56% LGE vs 39%, P = 0.17),左心房腔的大小(58±8毫米与LGE vs 61±10毫米,P = 0.15),或者教育法的时机CMR研究后,元太(36±10天LGE vs 60±66天没有,P = 0.09)。结论：虽然在PVI前很少见，但在PVI后几乎三分之一的患者中可以看到新的食管LGE。临床意义仍有待探讨，但临床医生应该意识到这种常见的影像学发现。（pace 2010; 33:661-666）
Background:Pulmonary vein isolation (PVI) as a treatment for atrial fibrillation (AF) is commonly performed. This procedure can damage the esophagus. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) offers noninvasive assessment of scar. We sought to examine the prevalence of esophageal hyperenhancement on LGE‐CMR prior to and following PVI.Methods:Seventy‐four patients underwent LGE‐CMR prior to and 1.7 ± 1.9 months post PVI for AF. Transmural esophageal hyperenhancement was visually assessed. The pre‐ and post PVI esophageal position was measured, relative to the vertebral body.Results:Prior to PVI, 3% (2/74) of patients had esophageal LGE on CMR. At post‐PVI follow‐up, 30% (23/74) of the studies demonstrated new esophageal hyperenhancement adjacent to an ablation site. Most (74%, 17/27) positive esophageal LGE studies were performed >30 days after PVI, while no (0/9) studies performed >2 months post PVI were positive for esophageal hyperenhancement. The presence of post‐procedural esophageal hyperenhancement was not associated with longer ablation time (P = 0.42), use of an irrigated catheter (74% with LGE vs 47% without, P = 0.16), right‐sided esophageal location (56% with LGE vs 39% without, P = 0.17), size of left atrium cavity (58 ± 8 mm with LGE vs 61 ± 10 mm without, P = 0.15), or the timing of the LGE‐CMR study after PVI (36 ± 10 days with LGE vs 60 ± 66 days without, P = 0.09).Conclusion:Though rare before PVI, new esophageal LGE is seen in almost one‐third of patients after PVI. The clinical implications to remain to be explored, but clinicians should be aware of this frequent imaging finding. (PACE 2010; 33:661–666)