目的 评估单心动周期实时三维超声技术的经食管心脏超声(TEE)在评估心房颤动(简称房颤)患者肺静脉解剖结构及内径的临床价值.方法 74例因房颤拟初次行射频消融手术患者,术前常规行采用单心动周期实时三维TEE检查、电子计算机断层扫描(CT)肺静脉血管造影及三维重建对比检查.结果 与CT对比,TEE肺静脉检出率:右上肺静脉71/72(99％),右下肺静脉70/72(97％),74/74左上肺静脉(100％),70/74左下肺静(95％).对于变异肺静脉,利用单心动周期实时三维TEE分别检出:7/10(70％)右中肺静脉,2/3(67％)左中肺静脉,1/2(50％)右肺静脉共干.CT与TEE对比测量静脉开口内径分别为右上肺静脉(20.59±4.75)mm vs(19.10±4.13) mm,右下肺静脉(17.48±2.97)mm vs(13.35±3.02)mm,左上肺静脉(21.78±3.77)mm vs(18.63±3.41)mm,左下肺静脉(18.13±3.31)mm vs(12.47±3.25)mm(P均<0.001).结论 利用单心动周期技术的TEE可协助检出肺静脉及变异肺静脉,但与CT对比肺静脉开口的内径测值低.%Objective To compare single cardiac cycle real-time three-dimensional transesophageal echocardiography(TEE)with computed tomography(CT)in evaluation of the anatomical structure and inner diameter of pulmonary veins in patients with atrial fibrillation. Methods Among the 74patients,the anatomy and inner diameter of pulmonary veins were assessed by both TEE and CT before the procedure of radiofrequency ablation. Results By using the CT assessment as references,the detect rate of TEE were 99％and 97％for the right superior and inferior pulmonary veins,100％and 95％for the left superior and inferior veins.7(70％)cases of variant right middle and 2(67％)of left middle pulmonary vein were successfully identified by TEE.The inner diameters of pulmonary veins measured by TEE vs CT were as follows:right superior(19.10±4.13)mm vs(20.59±4.75)mm,right inferior(13.35±3.02)mm vs(17.48±2.97)mm,left superior(18.63±3.41)mm vs(21.78±3.77)mm,and left inferior(12.47±3.25)mm vs(18.13±3.31)mm (P<0.001for all),respectively. Conclusion The single cardiac cycle real-time three-dimensional TEE has a high detectability of pulmonary veins,however the inner diameters of the veins are smaller detected by TEE compared with the CT reference.
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