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目的:应用多层螺旋计算机断层摄影术(MSCT)探讨心房颤动(房颤)者冠状静脉窦及左心房形态学的变化。方法:因房颤行MSCT肺静脉成像和行冠状动脉血管成像检查的患者,共收取冠状静脉窦图像质量最佳者100例,分为房颤组[50例:女20例,平均年龄(50.5±13.0)岁]及对照组[50例:女23例,平均年龄(53.6±13.0)岁]。测量冠状静脉窦口的直径(上下径和前后径)、距冠状静脉窦口1 cm、2 cm处冠状静脉窦的直径(上下径和前后径)及各处面积;左心房的直径。结果:房颤组与对照组比较:冠状静脉窦口直径[上下径:(19±7)mm vs(16±8)mm,P=0.05;前后径:(13±2)mmvs(11±3)mm,P=0.01]、距冠状静脉窦口1 cm处冠状静脉窦直径[上下径:(15±1)mm vs(13±2)mm,P<0.01;前后径:(11±5)mm vs(11±1)mm,P=0.03]和左心房直径[上下径(45±4)mm vs(31±7)mm,P=0.04;前后径:(53±4)mm vs(44±5)mm,P<0.01]房颤组明显高于对照组。结论:房颤者冠状静脉窦及左心房发生形态解剖重构;其形状与正常人群无差异,其中管状冠状静脉窦占82%。
Objective: To investigate the morphological changes of coronary sinus and left atrium in patients with atrial fibrillation by multi-slice spiral computed tomography (MSCT). Methods: A total of 100 patients with coronary sinus image quality were included in this study. They were divided into three groups: atrial fibrillation group (50 cases: 20 females, average age 50.5 ± 13.0) years old and control group (50 cases: 23 females with an average age of 53.6 ± 13.0 years). The diameter of the coronary sinus ostium (diameter and anteroposterior diameter), the diameter of the coronary sinus (diameter and anteroposterior diameter) at 1 cm and 2 cm from the coronary sinus ostium and the area of the coronary sinus were measured. The diameter of the left atrium was measured. Results: Compared with the control group, the diameter of coronary sinus ostium in the atrial fibrillation group was significantly lower than that in the control group (upper and lower diameter: (19 ± 7) mm vs (16 ± 8) mm, P = ) mm, P = 0.01], the diameter of coronary sinus at 1 cm from the coronary sinus ostium (upper and lower diameter: 15 ± 1 mm vs 13 ± 2 mm, P <0.01) (53 ± 4) mm vs (44 ± 4) mm vs (31 ± 7) mm, P = 0.03; and left atrial diameter [ ± 5) mm, P <0.01] AF group was significantly higher than the control group. Conclusion: The morphology of the coronary sinus and left atrium in atrial fibrillation is anatomic and reconstructed. There is no difference between the shape of coronary sinus and the left atrium in patients with atrial fibrillation. The diameter of coronary sinus is 82%.