摘要
目的探讨256层螺旋CT左心房肺静脉双期扫描成像(简称CT双期成像)在非瓣膜病心房颤动患者射频消融术中的应用价值。方法回顾性分析首都医科大学附属北京天坛医院2018年10月至2020年9月74例非瓣膜病心房颤动患者的临床资料。患者均行CT双期成像和经食管超声心动图(TEE)检查,以TEE结果为"金标准",评价CT双期成像对左心房血栓前状态(PTS)和血栓的诊断价值,并观察肺静脉变异情况。结果CT双期成像诊断左心房PTS的灵敏度为52.94%(9/17),特异度为92.45%(49/53),阴性预测值为85.96%(49/57),阳性预测值为69.23%(9/13);诊断左心房血栓的灵敏度为100.00%(4/4),特异度为90.74%(49/54),阴性预测值为100.00%(49/49),阳性预测值为44.44%(4/9)。肺静脉变异率为21.62%(16/74)。结论CT双期成像对左心房血栓具有高灵敏度、高特异度和高阴性预测值,并可详细评价肺静脉解剖特征,发现肺静脉变异,为非瓣膜病心房颤动射频消融术提供可靠依据。
Objective To explore the application value of 256-layer spiral CT left atrial pulmonary vein dual phase scanning imaging(called simply CT dual phase scanning imaging)in radiofrequency ablation of nonvalvular atrial fibrillation.Methods The clinical data of 74 patients with nonvalvular atrial fibrillation from October 2018 to September 2020 in Tiantan Hospital,Capital Medical University were retrospectively analyzed.All patients were examined by CT dual phase scanning imaging and transesophageal echocardiography(TEE).The result of TEE was as"gold standard",the value of CT dual phase scanning imaging in the diagnosis of left atrial pre-thrombotic state(PTS)and thrombus were assessed,and the variation of the pulmonary vein was observed.Results CT dual phase scanning imaging in diagnosis of left atrial PTS had a sensitivity of 52.94%(9/17),a specificity of 92.45%(49/53),a negative predictive value of 85.96%(49/57),and a positive predictive value of 69.23%(9/13);it in diagnosis of left atrial thrombus had a sensitivity of 100.00%(4/4),a specificity of 90.74%(49/54),a negative predictive value of 100.00%(49/49),and a positive predictive value of 44.44%(4/9).The variation rate of the pulmonary vein was 21.62%(16/74).Conclusions CT dual phase scanning imaging has relatively high values of sensitivity,specificity and negative predictive value in detecting left atrial PTS and thrombus.It can also evaluate the abnormal anatomical characteristics of the pulmonary vein,and find pulmonary vein variation.It provides a reliable basis for radiofrequency ablation of nonvalvular atrial fibrillation.
作者
杨蓉
克德娜
张妍
张萌
甘露
荆利娜
Yang Rong;Ke Dena;Zhang Yan;Zhang Meng;Gan Lu;Jing Lina(Department of Radiology,Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Ultrasonography,Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国医师进修杂志》
2021年第7期581-585,共5页
Chinese Journal of Postgraduates of Medicine
关键词
体层摄影术
螺旋计算机
心房颤动
导管消融术
左心房肺静脉双期成像
Tomography,spiral computed
Atrial fibrillation
Catheter ablation
Left atrium pulmonary vein dual phase imaging
作者简介
通信作者:荆利娜,Email:jinglina606@163.com,电话:010-59975392。
