Document Detail


Pulmonary venous evaluation using electrocardiogram-gated 64-detector row cardiac CT.
MedLine Citation:
PMID:  22167511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Radiofrequency ablation of the pulmonary veins is an accepted treatment for atrial fibrillation. An accurate knowledge of pulmonary venous anatomy and dimensions is desirable prior to such a procedure. The objective of this study was to use 64-detector row cardiac CT to investigate the changes in pulmonary venous dimensions during the cardiac cycle.
METHODS: Data from 44 consecutive patients with no significant cardiovascular pathology who underwent electrocardiogram (ECG)-gated 64-detector row coronary angiography were retrospectively analysed. Average diameter and cross-sectional area were measured at 5 mm intervals from each pulmonary vein ostium, in ventricular end-diastole and ventricular end-systole, using curved multiplanar reformats.
RESULTS: 4 (9.1%) patients had pulmonary vein anomalies and were excluded. In the remaining 40 patients, pulmonary vein diameter and area at the ostium were significantly larger in end-systole in all four veins, with the largest differences in the superior pulmonary veins. Dimensional changes for diameter (millimetres) and area (square millimetres) were as follows: left superior pulmonary vein, 2.5 (p<0.001), 65.48 (p<0.001); right superior pulmonary vein, 1.63 (p<0.001), 56.27 (p<0.001); left inferior pulmonary vein, 1.1 (p<0.001), 30.41 (p<0.001); and right inferior pulmonary vein, 0.68 (p=0.005), 30.14 (p=0.005). Less marked changes were seen at measurement sites further from the atrium. Interobserver correlation was high (all but one measurement >0.9).
CONCLUSION: Pulmonary vein dimensions change significantly between end-systole and end-diastole, and the ostia of the superior pulmonary veins are potentially the most vulnerable to dimensional inaccuracies. ECG-gated cardiac CT may provide a more precise method of pulmonary venous dimensional measurement than non-gated techniques. Knowledge of change in pulmonary vein diameter offers interesting potential research into the effect of pulmonary vein function.
Authors:
N E Manghat; H C Mathias; N Kakani; M C K Hamilton; G Morgan-Hughes; C A Roobottom
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-12-13
Journal Detail:
Title:  The British journal of radiology     Volume:  85     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-29     Completed Date:  2012-09-12     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  965-71     Citation Subset:  AIM; IM    
Affiliation:
Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK. Nathan.manghat@UHBristol.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / physiopathology,  radiography,  surgery*
Cardiac-Gated Imaging Techniques / methods*
Catheter Ablation / methods
Cohort Studies
Coronary Angiography / methods*
Female
Humans
Imaging, Three-Dimensional
Male
Observer Variation
Preoperative Care / methods
Pulmonary Veins / abnormalities,  radiography*,  surgery
Radiographic Image Interpretation, Computer-Assisted*
Retrospective Studies
Sensitivity and Specificity
Statistics, Nonparametric
Tomography, X-Ray Computed / methods*
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