| objective: to Inquiry into a method to measure the diameter of pulmonary veins ostia with multislice spiral CT(MSCT) .The material and method: we prospectively collected 220 cases of adults to our hospital from June 2005 to December 2006(male 120 ,female 100 ,20-83y, 48±9.8).All have no illness in lung and mediastinum, having no hypertension ,diabetes mellitus .All have 4 separated ostial pulmonary veins. All patients were examined with ECG-gated MSCT (GE Lightspeed 16).imaging were obtained during a single breath hold at full inspiration ,from the top of the truncus pulmonalis through the apex, with the following parameters: collimation, 1.25mm; table speed,13.75mm per rotation; and rotation,0.5 secon scans triggered at 75% R-R interval. A total of 60～100ml of noniodinated contrast material was injector at a rate of 3.5ml/s;scanning commenced after a 22 - 28 second delay. Standard algorithm with values of 120KW and 300～320mA.Interpretation of the scan was performed on conventional contrast enhanced axial slices and 3D volume rendering images ,and the images thus obtained were compared with each other .CT images were evaluated by searching these parameters: the superior-inferior diameter and anterior-posterior diameter of the pulmonary veins ostia evaluated from VR and axial slices . The superior-inferior diameter of pulmonary vein stem of the ostial department; the diameter of pulmonary veins apart from ostial department 5 mm,10 mm,15 mm,20 mm obtained from VR, the pulmonary vein ostial branches and a venous ostium index was calculated for all veins. A probability value P<0.05 was considered statistically significant, P<0.01 was considered quite statistically significant.Result: the diameters of pulmonary vein ostia are each not same. The images obtained in VR: The ostial diameter of the male pulmonary veins for right superior pulmonary vein(RSPV)(19.4±4.0×15.0±1.7) mm, right inferior pulmonary vein(RIPV)(16.5±2.6×14.1±1.7) mm, left superior pulmonary vein(LSPV)(24.5±5.8×13.7±3.1) mm, left inferior pulmonary vein(LIPV)(16.4±3.9Χ11.9±3.3) mm; The diameter of the female pulmonary vein ostia for RSPV(18.2±3.8×15.4±3.3) mm, RIPV(15.1±2.8×13.5±0.8) mm, LSPV(19.8±7.2×13.5±2.7) mm, LIPV(16.1±3.5×11.7±1.5) mm. On the coronal plane and the cross section imagers: The ostial diameter of the male pulmonary veins for RSPV(19.4±3.6×15.0±2.5) mm, RIPV(16.3±3.2×14.4±2.8) mm, LSPV(23.4±5.6×14.1±4.2) mm, LIPV(16.1±3.5×12.1±4.7) mm; The diameter difference of the female lung vein openings department for RSPV(17.7±4.2×15.5±5.0) mm, RIPV(15.0±s 3.1×13.8±2.4) mm, LSPV(18.5±4.8×14.1±1.7) mm, LIPV(15.5±2.7×12.0±2.1) mm. The data acquired by two methods has no obvious difference(P<0.05).The male's LSPV ostial diameter is significant larger than female's (P<0.01), three pulmonary veins ostial diameter of rest men and women have no obvious difference. The caliber of the four veins gradually increased as they approached the left atrium, and have no a pulmonary vein ostia circular , all is look like in oval, Venous ostium index of the LIPV is the smallest, but venous ostium index of the RIPV largest, indicating a circular. The pulmonary vein ostial branches emergence rate of the RIPV is the highest, among them male is 55.4%, female 61.2%; the pulmonary vein ostial branches emergence rate of the LSPV is the lowest, the male 1.8%, female 2.1%.Conclusion:(1)There is to be like to have no obvious difference in the aspects of measuring the pulmonary vein ostial diameters between VR and axial slices; but the axial slices become to be like more simple and accurate .VR can be an important assistant.(2) The male's LSPV ostial diameter is significant larger than female's, three pulmonary veins ostial diameter of rest have no obvious difference between men and women.(3)The lung vein openings diameter and age have no obvious relativity.(4)The ostia of All the pulmonary veins are oval, and gradually increased as they approached the left atrium. The emergence of The pulmonary vein ostialbranches influenced the judgment of the narrow degree, expending to make misdiagnosis.
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