256层螺旋计算机断层摄影术对右心耳及其毗邻形态结构的定量研究

摘要

目的：采用256层螺旋计算机断层摄影术（MSCT）对右心耳及其毗邻的形态结构进行定量研究，为右心耳临床介入和外科治疗提供影像学依据。方法：回顾性分析我院行计算机断层摄影术血管造影（CTA）检查结果阴性者200例，男96例，女104例，<40岁者29例，40~60岁者114例，>60岁者57例。将原始扫描数据进行右心耳重建，对右心耳容积及径线等参数进行测量，并从性别和年龄方面进行比较，提出右心耳各参数95％正常参考值范围。结果：（1）右心耳容积、高度、基底部长径、基底部周长、正位展距男性均大于女性，差异均有统计学意义（P均<0.05）。经体表面积标化后，右心耳基底部长短径、面积及周长女性均大于男性，差异均有统计学意义（P均<0.05）。（2）<40岁者右心耳正位展角及正位展距较40~60岁及>60岁者大（P<0.05），40~60岁者与>60岁者间差异无统计学意义（P>0.05）。（3）提出右心耳各参数95％正常参考值范围：容积4.83~19.97 ml、高度21.46~41.80 mm、基底部长径25.89~41.65 mm、基底部短径19.34~36.24 mm、基底部面积459.30~1093.28 mm2、基底部周长86.16~147.04 mm、正位展角1.67°~31.23°、正位展距8.07~34.37 mm。结论：256层MSCT可以对右心耳解剖结构相关参数进行定量研究，并初步建立右心耳各参数95％正常参考值范围，为临床治疗右心耳相关疾病提供影像学参考。%Objective: To quantitatively study the morphological structure and parameter of right atrial appendage (RAA) by 256-slice spiral CT to provide RAA imaging reference for interventional or surgical therapy in clinical practice. Methods: A total of 200 patients with negative CTA results examined in our hospital were studied including 96 male and 104 female; by age division, Age≤40 years group,n=29, Age (40-60) years group,n=114 and Age>60 years group,n=57. The original scanning data was reconstructed for RAA establishment, indexes of volume, radial lines were measured and compared between different gender and age groups to obtain 95% normal imaging references of RAA. Results:①The volume, height, basilar part circumference, anteroposterior spread of RAA in male were greater than female, allP<0.05; with surface area standardization, the long and short diameter of basilar part, area, circumference in female were greater than male, allP<0.05.②Anteroposterior angle and spread of RAA in Age<40 years group were higher than both Age (40-60) years group and Age>60 years group,P<0.05, the above parameters were similar between Age (40-60) years group and Age>60 years group,P>0.05.③95% normal reference ranges of RAA were as following: volume (4.83-19.97) ml, height (21.46-41.80) mm; basilar part longest diameter (25.89-41.65) mm, short diameter (19.34-36.24) mm, area (459.30-1093.28) mm², circumference (86.16-147.04) mm; anteroposterior angle (1.67-31.23) °, spread (8.07-34.37) mm. Conclusion: 256-slice CT may quantitatively study the morphological structure and parameter of RAA and establish its 95% normal imaging references for clinical practice.