The Application Research Of Dsct In Pulmonary Vein Anatomy And Variation

ObjectiveTo explore pulmonary vein anatomy and variations by using the dual-source Flash CTwith a variety of post-processing for guiding catheter ablation of atrial fibrillation (AF) andproviding accurate anatomy information for clinician.Method300patients with clinically suspected coronary atherosclerotic heart disease, aorticdisease or medical examination accepted the dual-source Flash CT coronary artery imaging,excluding these patients which may effect the pulmonary vein anatomy and disease, noheart and lung operation were retrospectively analyzed, among which210patients weremale and90patients were female, age14years~81years old. Select the best diastphasedata transferred to the post-processing workstation, all cases based on CT axial images,through the post-processing technolgoy including volume rendering (VR), maximumintensity projection (MIP) and multi-planar reconstruction (MPR) were observed andanalyzed. For the error caused by a reduction in certain limitation factors, and quoted CTvirtual endoscopy (CTVE), the analysis Pulmonary vein carina from the lumen of the leftatrium internal comprehensive observation, will make the diagnosis more clear. By manyof post-processing techniques, observation and analysis of the pulmonary vein anatomyand variation is conducted, at the same time, we made the census of the occurrence rate ofevery type.ResultsOf300cases,116cases were found with variation of plumary vein, of the totalvariance was38.7%(116/300),61case in left plumary vein, with the variation rate of20.3%;72case in the right plumary vein, with the variation rate of24%, There is nosignificant difference found between each other.According to the different number ofpulmonary vein opening,common pulmonary vein and accessory pulmonary veins, the pulmonary vein is divided into four types:①stardard type(184cases): the most common，accouting for61.3%;②pulmonary vein common trunk type (52cases): accouting for17.3%. among these cases,41cases (13.7%) in the left pulmonary vein,10cases (3%) inthe right pulmonary vein,1case (0.3%) in both sides of pulmonary vein;③accessorypulmonary vein (48cases): accouting for16%, there were2cases found in the leftpulmonary vein, with the variation of0.67%,37cases found in the right pulmonary vein,with the variation of12.3%,9cases found in top of the pulmonary vein, with the variationof3%;④composite variation type (16cases): accouting for5.3%, the common truck ofthe left pulmonary vein accompanying with the vice pulmonary vein.ConclusionThe findings indicate that mutation rate of pulmonary vein anatomy is high, amongthese, the primary variation type is pulmonary vein common trunk type, vice pulmonaryvein type second during the research, merits and disadvantages were found in thepost-processing techniques of dual-source Flash CT, It is necessary to integrate with allpost-processing methods of dual-source Flash CT, which are able to make more preciseanalysis on Pulmonary vein anatomy.ApplicationBy integrating post-processing methods of dual-source Flash CT, we can observepulmonary veins and left atrium anatomical structure three-dimensionally, and then makesure whether there is variation. For some subtle anatomical structures, we can improve theaccuracy of diagnosis, especially by introducing the endoscopic observation of CTsimulation. Through the pulmonary vein anatomy classification and detailed statistics ofeach type of occurrence rate, our research is not only a supplementary research topulmonary vein anatomy, but also help guiding atrial fibrillation radiofrequency ablationand thoracic surgery, reducing the occurrence of postoperative complications.