102例房颤患者冠状窦的放射解剖学参数（64排CT测量报告）

目的：通过64排螺旋CT增强扫描三维软件分析102例患者冠状窦的放射解剖学参数，为置管及导管设计提供参考。方法：选择102例拟行阵发性房颤消融的患者，术前行64排螺旋CT增强扫描检查，采用软件Advantage Workstation 4.3（GE Medical System）多个切面分析，三维重建冠状窦和心脏外形，测量主动脉直径、胸椎高度、冠状窦开口段的方向、直径、末段直径，冠状窦开口高度距心脏下缘的距离，分析冠状窦直径、开口高度与身高、体质量、胸椎位置关系、心脏外形的相关性。结果：冠状窦开口向上（与轴面成角27.4°±10.2°）指向右前方（与矢状面成角31.1°±11.4°），冠状窦开口直径最小12.4 mm×4.3 mm，最大37.3 mm×21 mm，其末段直径（8.9±2.7） mm。冠状窦开口高度，以胸骨角平面向下记录，平均值为4.8±0.7个椎体高度，窦口距离心脏下缘水平线上平均（27.8±8.5） mm（1.2个椎体高）。冠状窦开口与心脏外形成角相关性较佳，横位心冠状窦口显著下移。结论：冠状窦开口向上且指向右前方，开口段直径变异巨大。冠状窦开口高度与胸椎绝对位置相关性差，而与心脏是否横位相关，一般位于心脏下缘水平线上约1.2个椎体高。

Radioanatomic parameters of coronary sinus in 102 patients with paroxysmal atrial fibrillation

Objective： To study the radioanatomic parameters of coronary sinus using 64-row CT for guiding catheter implantation and design.Methods： One hundred and two cases of patients with paroxysmal atrial fibrillation underwent 64-row cardiac enhanced CT as a routine examination before ablation.Advantage Workstation 4.3（GE Medical System） was used for multi-slice analysis and reconstruction of three-dimensional cardiac image of interest.The diameter of aorta,the height of the thoracic vertebrae,the orientation of coronary sinus orifice（CSO）,the diameter of CSO,the height of CSO from the inferior margin of the heart.The relation of CSO diameter and the height of CSO to the height of the body,body weight,the location of thoracic vertebrae,and the cardiac silhouette were analyzed.Results： CSO pointed upward（27.4°±10.2° to the axial plane）,rightward and anterior（31.1°±11.4° to the sagittal plane）.The minimum diameter of CSO was 12.4 mm×4.3 mm and the maximum diameter was 37.3 mm×21 mm.The terminal diameter of CSO was（8.9±2.7） mm.The location of CSO was 4.8±0.7 times the height of vertebrae inferior to the sternal angle plane and was about（27.8±8.5） mm（1.2 vertebrae height） above the bottom of the heart.There was a better anatomical relation between the CSO and heart shape angular correlation.CSO in transverse heart was significantly lower.Conclusions： CSO opens upward and points rightward and anterior.The diameter of orifice has large variation.The location of CSO is more related to the horizontal degree of the heart and about 1.2 times the vertebrae height above the bottom of the heart.