Phrenic Nerve Identification By Pericardiophrenic Branching Using Multisliecs Helieal CT

Background:Phrenic Nerve Injury(PNI) can always be seen after cardiac surgeons. Recently, it has been recongnized as a common complication during catheter ablation and cardiac resynchronization therapy(CRT). This study aimed to analyse the anatomy of the PN by multisliecs helieal CT. Methods :Retrospect consecutive 100 patients who underwent cardiovascular computed tomography(CT) by using pericardiophrenic branching combining multi-planner reformation(MPR) and volume rendering(VR) techniques. Messure the distance between bilateral phrenic nerves and vital anatomic structures respectively. Make the statistics of the structures which hold the distance between phrenic nerves within 5mm and the ratio. Results:The right pericardiophrenic bundles(RPCB) was identified in 53 of 100 patients(53%). It holds the distance between the right superior pulmonary vein( RSPV) and RPCB within 5mm accounting for 92.5%, RSPV ostium 13.2%, and only 3.8% of the distance less than 5mm between RPCB and right inferior pulmonary vein(RIPV), and there is no case of the distance between RPCB and RIPV ostium less than 5mm. However, the left pericardiophrenic bundles’(LPCB) identification success rate was 90%(90/100),and held the distance less than 5mm with left atrial appendage at the persentage of 62.6%, great cardiac vein(36.1%), anterior interventricular vein(28.9%), middle cardiac vein(30%), posterior interventricular vein(91.1%), almost all the cases held a distance between LRPB and the LPV and their ostiums are more than 5 mm. Conclusion:MSCT could elucidate anatomic relationships and help minimize inadvertent complications before the procedure of electrophysiologic intervention.