| Objective: Anatomical shape variations of the left atrial appendage(LAA) were investigated and classified in vivo by256-slice spiral computedtomography coronary angiography (coronary CTA)3D reconstruction.Common types of LAA volume were measured and compared further more.This study completed cardiac imaging anatomical data and providedanatomical information for the diagnosis and treatment of LAA-relateddiseases.Methods: The scan data of670consecutive patients (433males and237females) who received256-slice coronary CTA were reconstructed at75%R-R interval followed by LAA3D reconstruction. Anatomical shape variationsof LAA were classified and the difference in gender among11subtypes wasinvestigated. Common types of LAA volume were measured and comparedfurther more.Results: On the basis of Mustafa Koplay’s classification, according totip orientation and anatomical shape, the LAA were divided into seven typeswith11subtypes, including Type1a (horseshoe-shaped), Type1b(cockscomb-shaped), Type2a (hand-finger-shaped), Type2b (fan-shaped),Type2c (wing-shaped), Type2d (“山”-shaped), Type3(hook-shaped), Type4(wedge-shaped), Type5(swan-shaped), Type6(bifurcation-shaped) and Type7(ring-shaped). There were Type1a at4.9%(n=33), Type1b at1.3%(n=9),Type2a at9.7%(n=65), Type2b at21.8%(n=146), Type2c at38.4%(n=257), Type2d at6.7%(n=45), Type3at3.1%(n=21), Type4at4.0%(n=27), Type5at5.5%(n=37), Type6at3.7%(n=25) and Type7at0.7%(n= 5), respectively. Only Type5was more frequently found in women than men(P=0.036)，no gender difference were find among other types. There was nosignificant difference in two common types LAA volume between Type2band Type2c (P=0.704).Conclusion: The LAA shape is complex. Advanced256-slice spiralcomputed tomography coronary CTA can objectively evaluate themorphological structure of multiple LAA variations and understanding thosevariations before invasive treatments has the potential to increase the successrate and to avoid post-procedure’s complications for patients withLAA-related diseases. Objective: To quantitatively study the important parameters of LAAanatomic structure by256iCT in order to provide reference for theinterventional therapy or surgical treatment of LAA disease.Methods: In the population of patients referred to our hospital for aconventional256-slice spiral CT coronary angiography,150consecutiveindividuals (80men and70women, with a mean age of50.5±9.1years)without cardiovascular disease were prospectively selected. The raw imageswere reconstructed at the75%R-R interval. The long diameter, short diameter,perimeter and area of LAA ostium, deep diameter, volume and angle of LAAwere measured using multi-planar reformatting (MPR) and volume rendering(VR). Statistical methods was used to acquire the normal reference range ofthe LAA structure parameters and analyse the relationship between LAAstructure parameters and gender,age, height and weight respectively. Thenanalyze them by statistics.Result:①LAA has1～3lobes including1lobe（50.8%），2lobes （41.1%）and3lobes（8.1%）.②The irregular shape of LAAostium could beclassified into5types including oval (81.5%), triangular (7.3%)，semicircle（4%），water drop-like (7.7%), round (5.7%) and foot-like (10%).③TheLong diameter of LAA ostium was greater than that in women（P=0.004）,other LAA parameters have no gender and age difference.④Correlation wasfound between LAA ostium and height.⑤There was correlation between thevolume of LAA and adjacent structure，but no correlation with individualfigure.⑥In addition to the angle，there were correlation between LAAparameters.⑦The95%medical reference ranges of Long diameter,shortdiameter, area and perimeter of LAA ostium, deep diameter, volume and angleof LAA was15.30～31.86mm,9.11～20.83mm,89.05～447.91mm2,43.83～84.09mm,29.11～54.05mm,2.46～10.66ml and80.62°～147.80°respectively.Conclusion:256-slice MSCT can objectively display and mesure LAAstructure. This study analysed the parameters of LAA anatomic structure andestablished normal reference range of the parameters, provided importantreference for diagnosis and treatment of LAA-related diseases. Objective: To quantitatively study the relationship and diameterbetween left atrial appendage（LAA）and adjacent anatomical structure by256iCT and provide reference data for AF ablation and LAA occlusion.Methods: In the population of patients referred to our hospital for aconventional256-slice spiral CT coronary angiography,150consecutiveindividuals (80men and70women, with a mean age of50.5±9.1years)without cardiovascular disease were prospectively selected. The raw images were reconstructed at the75%R-R interval. The relationship and diameterbetween LAA and adjacent anatomical structure were analysed and measuredusing MPR and VR. Then analyze them by statistics.Result: According to the anatomical location between the LAA and theleft superior pulmonary vein (LSPV),LAA was classified as type Ⅰ(9%),typeⅡ（78%） and typeⅢ (13%). LAA ridge was classified as type AI（17.6%），typeAⅡ（69.9%），type B（5.9%）and type C（6.6%）. The lengthof LAA ridge was（33.2±5.2）mm; The minimum distance from LAA to LSPVwas (1.3±0.9)mm; The distance between LAA ostium and LSPV ostium was（4.9±1.7）mm; The distance from LAA ostium to mitral annulus was(10.6±2.3）mm. The minimum distance from LAA to left circumflex arterywas（2.1±0.9）mm. The distance from LAA ostium to mitral annulus of maleswere greater than that of females (P=0.037)，whereas no significant differencewere found for the other parameters between males and females.Conclusion: The quantitative measurement between left atrialappendage and adjacent anatomical structure by256iCT provided importantheart anatomy data，which is a great clinical value for AF ablation and LAAocclusion. Objective: The purpose of this study is to assess the volume change atcardiac cycle and function of LAA using256-slice spiral CT coronaryangiography multi-phase three-dimensional volume rendering.Methods: In the population of patients referred to our hospital for aconventional256-slice spiral CT coronary angiography,40individuals(20menand20women, with a mean age of50.5±9.6years) without cardiovascular disease were prospectively selected. Ten data sets of transversal images werereconstructed every10%（5%～95%）of the R–R interval. All images wereanalyzed to observe the change of LAA volume in the cardiac cycle and toobtain the maximum and minimum of left atrial appendage volume(LAAVmaxand LAAVmin)，left atrial appendage ejection volume（LAAEV），and leftatrial appendage ejection fraction(LAAEF) by Philips EBW4.5workstation。Analysis the correlation between LAA parameters, and the correlationbetween LAA parameters and conventional physical index.Results: LAA emptied twice in a cardiac cycle，and its volume waschanging. Changes of LAA volume were small during65%～85%of cardiaccycle. In this period，LAA close to its natural state. LAAVmax, LAAVmin andLAAEV were positively correlated with height, weight and body surface arearespectively (r=0.540,0.533,0.588,0.449,0.407,0.458,0.522,0.538,0.587respectively)．LAAEF was negatively correlated with LAAVmin（r=-0.542）,not correlated with LAAVmax. No significant difference was found for eachparameter between males and females.Conclusion:256-slice spiral CT coronary angiography multi-phasethree-dimensional volume rendering is helpful to assess the changes of LAAvolumes and LAA function, which can provide important reference for clinicalapplication. |
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