| 摘要: |
| ［摘要］ 目的 基于CT心脏造影对缓慢性窦性心律失常患者的右心耳放射解剖学指标进行观测。方法 招募2017年1月至2018年5月在广西壮族自治区人民医院行心脏起搏器植入的缓慢性窦性心律失常患者74例作为病例组。另选择同期临床无典型心血管疾病症状体检者20例以及因其他系统疾病需行心脏CT筛查排除心脏风险的患者26例作为对照组（46例），其心电图无任何异常，心脏超声无明显结构和功能改变。两组均行128排CT心脏造影检查，应用Philips IntelliSpace Portal Workstation软件测量右心耳的轴位角、矢状位角、冠状位距离、斜上下径、左右径、周长等指标。结果 对照组右心耳轴位角为0.40～11.91（6.56±3.17）°，矢状位角为40.03～60.58（50.37±5.21）°，冠状位距离为4.75～8.89（6.96±1.08）cm，斜上下径为2.61～5.07（3.84±0.68）cm，左右径为1.87～4.18（3.01±0.59）cm，周长为10.31～14.27（12.38±0.92）cm。病例组右心耳的轴位角大于对照组，矢状位角小于对照组，差异有统计学意义（P<0.05），其他右心耳放射解剖学指标比较差异无统计学意义（P>0.05）。在男性中，病例组右心耳的轴位角大于对照组，矢状位角小于对照组，差异有统计学意义（P<0.05）。在女性中，病例组右心耳的轴位角大于对照组，矢状位角、斜上下径小于对照组，差异有统计学意义（P<0.05）。在<60岁者中，病例组右心耳的轴位角大于对照组，矢状位角小于对照组，差异有统计学意义（P<0.05）。在≥60岁者中，病例组右心耳的矢状位角小于对照组，差异有统计学意义（P<0.05）。结论 通过CT心脏造影可较为客观地对右心耳解剖学形态进行观测，对临床起搏器植入具有指导意义。 |
| 关键词: 右心耳 CT心脏造影 起搏器植入 放射解剖学指标 |
| DOI：10.3969/j.issn.1674-3806.2025.02.16 |
| 分类号: |
| 基金项目:广西卫生和计划生育委员会自筹经费科研课题（编号：Z2016575） |
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| Observation on radioanatomical indicators of the right atrial appendage in patients with brady sinus arrhythmia based on cardiac CT angiography |
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LI Weijun1, ZHAO Chunli2, DENG Jinlong1, WEI Youyong2, WU Dongfeng1, GUAN Xiaohui2, WU Yinxiong1
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1.Department of Geriatric Cardiovascular Medicine, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China; 2.Department of Radiology, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To observe radioanatomical indicators of the right atrial appendage in patients with brady sinus arrhythmia based on cardiac computed tomography(CT) angiography. Methods A total of 74 patients with brady sinus arrhythmia who underwent pacemaker implantation in the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2017 to May 2018 were recruited as case group. Other 20 individuals without typical cardiovascular disease symptoms who received physical examination during the same period and 26 patients who suffered from other systemic diseases and needed cardiac CT screening to exclude cardiac risk were selected as control group(46 cases). The control group had normal electrocardiogram, with no obvious structural or functional changes in cardiac ultrasound examination. Cardiac 128-row multidetector CT angiography was performed in both groups. Philips IntelliSpace Portal Workstation software was used to measure the axial angle, sagittal angle, coronal distance, oblique vertical diameter, transverse diameter, circumference and other indicators of the right atrial appendage. Results In the control group, the axial angle of the right atrial appendage ranged from 0.40° to 11.91°, with an average of (6.56±3.17)°, and the sagittal angle of the right atrial appendage ranged from 40.03° to 60.58°, with an average of (50.37±5.21)°, and the coronal distance of the right atrial appendage ranged from 4.75 cm to 8.89 cm, with an average of (6.96±1.08)cm, and the oblique vertical diameter of the right atrial appendage ranged from 2.61 cm to 5.07 cm, with an average of (3.84±0.68)cm, and the transverse diameter of the right atrial appendage ranged from 1.87 cm to 4.18 cm, with an average of (3.01±0.59)cm, and the circumference of the right atrial appendage ranged from 10.31 cm to 14.27 cm, with an average of (12.38±0.92)cm. The axial angle of the right atrial appendage in the case group was greater than that in the control group, and the sagittal angle of the right atrial appendage in the case group was smaller than that in the control group, and the differences were statistically significant(P<0.05), but there were no statistically significant differences in the other radioanatomical indicators of the right atrial appendage between the two group(P>0.05). In the males, the axial angle of the right atrial appendage in the case group was greater than that in the control group, and the sagittal angle of the right atrial appendage in the case group was smaller than that in the control group, and the differences were statistically significant(P<0.05). In the females, the axial angle of the right atrial appendage in the case group was greater than that in the control group, and the sagittal angle and the oblique vertical diameter of the right atrial appendage in the case group were smaller than those in the control group, and the differences were statistically significant(P<0.05). In the subjects <60 years, the axial angle of the right atrial appendage in the case group was greater than that in the control group, and the sagittal angle of the right atrial appendage in the case group was smaller than that in the control group, and the differences were statistically significant(P<0.05). In the subjects ≥60 years, the sagittal angle of the right atrial appendage in the case group was smaller than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The anatomical morphology of the right atrial appendage can be observed objectively by using cardiac CT angiography, which has guiding significance for pacemaker implantation in clinical practice. |
| Key words: Right atrial appendage Cardiac computed tomography(CT) angiography Pacemaker implantation Radioanatomical indicators |
