| PART Ⅰ FORCE CT Retrospective ECG-gated absolute phase one-stop evaluate of coronary artery,left atrium and pulmonary vein image quality and radiation doseObjective Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia in adults.The incidence and prevalence of AF continue to increase,driven by aging of the world population and upsurge in risk factors,such as hypertention,heart failure,obbesity,and sleep apnea.However,AF with irregular heart rate used to be a contraindication for CCTA.We will investigate the quality and radiation dose of Force CT retrospective ECG-gated absolute phase in one-stop assessment images of coronary,left atrium and pulmonary veins in patients with atrial fibrillation(AF).Materials and methods CCTA was consecutively performed in 40 patients with atrial fibrillation from March 2019 to November 2020.Calculating the dosage of contrast agent.The subjective image quality of coronary artery,left atrium and pulmonary vein was evaluated.Objective image quality of coronary artery,left atrium and pulmonary vein was measured as signal-to-noise(SNR)and contrast-to-noise ratio(CNR),the CT Record volume dose index(CT dose index volume,CTDIvol),the effective dose(ED)were analyzed.Results The dosage of contrast agent was(30-55)mL,average dosage is 44.29 mL.The Kappa value of images of coronary artery was 93.8%,and the consistency was better.The image quality scores in 40 atrial fibrillation patients was right coronary artery(RCA)(4.35±0.52),left main artery(LMA)(4.28±0.45),left anterior desceding(LAD)(4.12±0.52),left circumflex(LCX)(3.89±0.60)respectly and the image quality scores of RCA was higher than LMA,the scores of which was higher than LAD,while the scores of LCX was lower than LAD;There were 507 coronary artery segments,RCA,LMA,LAD and LCX segments displayed was 153,40,173 and 141 respectively,all segments could be evaluated.The Kappa value of images of left atrium and pulmonary vein was 79.5%,the consistency was better;26 patients scored 3 points,12 patients scored 2 points,and 2 patients scored 1 point.The SNR and CNR of coronary artery images were(24.75±4.98),(30.10±6.20)respectively.The SNR and CNR of left atrium was(18.83±4.82),(24.06±5.53)respectively;the SNR and CNR of pulmonary vein was(16.15±4.33),(20.91±4.9)respectively.CTDIvol,DLP and ED was(38.01 ± 14.34)mGy,(603.14±278.10)mGy·cm and(8.60±3.65)mSv respectively.Conclusion Coronary artery,left atrium and pulmonary vein one-stop imaging can obtain diagnostic images using Force CT retrospective ECG gated absolute phase in patients with atrial fibrillation,and radiation dose is within acceptable。PART Ⅱ The diagnostic value of Force CT one-stop imaging of coronary artery,left atrium and pulmonary vein in patients with atrial fibrillationObjective Atrial fibrillation(AF)is characterised by very rapid and uncoordinated atrial activity with worse morbidity and mortality;AF are frequently found in pulmonary veins(PV).These triggers originate from prolongations of the the atrial muscle at the PV level with a complex fiber arrangement at the Pvjunction with the left atrium(LA).Ablation,which isolates the PV,is established in patients suffering from drug-refractory symptomatic atrial fibrillation.Besides PV isolation,the atrial substrate modification is also performed.Even with experience in ablation,knowledge of left atrial anatomy and pulmonary vein anatomy is necessary.The left atrium(LA)and pulmonary vein(LV)anatomy can be obtained by several different imaging methods including transesophageal or intracardiac echocardiography,angiography,multislice computed tomography(MSCT)or three-dimensional gadolin-enhanced magnetic resonance.The MSCT is one of the most common methods.This study was designed to evaluate left atrial anatomy and pulmonary vein anatomy in patients with atrial fibrillation based on coronary artery images,to evaluate the severity of coronary artery disease,the anatomy and morphology of left atrium and pulmonary vein.To understand the structure of left atrium,pulmonary vein and select the surgical operation before surgery and to provide reference postoperative follow-up for patients with atrial fibrillation.Materials and methods CCTA was consecutively performed in 40 patients with atrial fibrillation from March 2019 to November 2020.The coronary artery image was used to evaluate the degree of coronary artery disease and to analyze the morphological and developmental variation of pulmonary vein.The anterior and posterior diameter,upper and lower diameter,mean diameter and finger value of pulmonary vein were measured;the left atrial diameter was measured.Results In 40 patients,26 vessels were slightly narrow,26 vessels were mildly narrow,10 vessels were moderately narrow,and 9 vessels were severely narrow or even obstruction.In 40 patients,35 of the standard four pulmonary veins(composition ratio 87.5%),4 of the right middle pulmonary vein(composition ratio 10%)and 1 of the left common pulmonary vein(composition ratio 2.5%).The upper pulmonary vein opening diameter line is larger than the lower pulmonary vein,the right pulmonary vein opening diameter line is larger than the left pulmonary vein,the common pulmonary vein opening diameter line is the largest,and the right middle pulmonary vein opening diameter line is the smallest.The right pulmonary vein was more round than the left pulmonary vein;The RMPV was the most round(1.00±0.15)and the LIPV was the most oval(0.86±0.14).The maximum transverse diameter of left atrium was(73.38±15.26)mm,the upper and lower diameters were(72.76±11.70)mm and the anterior and posterior diameters were(47.45± 10.63)mm.Conclusion Force CT coronary artery CT angiography can be used to evaluate coronary artery disease and evaluate left atrium and pulmonary vein anatomy one-stop in patients with atrial fibrillation.It can help to understand the structure and to select surgery of left atrium and pulmonary vein before operation and to provide reference data for postoperative following up in patients with atrial fibrillation.It has great clinical value. |
