Upper-Silesian Medical Center, Electrocardiology Department, Katowice 40-635, ul Ziolowa 45/47, Poland.
Circ J. 2011;75(3):613-8. doi: 10.1253/circj.cj-10-0736. Epub 2011 Jan 14.
In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT).
In 199 patients (114 males, age 56.6±11.5 years), a 64-slice computed tomography (Aquilion 64) was performed due to coronary artery disease suspicion. A scan with electrocardiogram-gating was performed using a slice thickness of 0.5mm during a breath-hold. In each case, 3D volume rendering and 2D multi-planar reformatting reconstructions of CVS were created (Vitrea 2). As target veins for cardiac resynchronization therapy (CRT), the posterolateral, lateral and anterolateral veins were recognized. Coronary sinus was well visualized in all cases. A total of 27 anatomical variants of CVS were identified, 9 of them are most common (in 148/199 cases; 74.4%). In 4 out of these 9 variants, a single coronary vein in the target area for CRT appeared, 2 target veins in 3 variants and 3 veins in 2 variants occurred. In 6 cases (2 seldom variants-3.0%) no veins in the target area were identified.
In the majority of the examined patients, at least one vein in the target area for CRT was observed. Anatomical variability of CVS strengthen the potential role of MSCT in CVS visualization before CRT implantation.
在一些研究中，已经记录到冠状静脉系统（CVS）存在巨大的解剖学变异性，但没有对其变异进行分析。本研究旨在通过多层螺旋 CT（MSCT）评估 CVS 的解剖学变异。
在 199 例患者（114 例男性，年龄 56.6±11.5 岁）中，由于怀疑冠心病而行 64 层 CT（Aquilion 64）检查。使用心电门控进行扫描，扫描时屏气，层厚 0.5mm。在每种情况下，均创建 CVS 的 3D 容积再现和 2D 多平面重建（Vitrea 2）。作为心脏再同步治疗（CRT）的靶静脉，识别了后外侧、外侧和前外侧静脉。所有病例均能很好地显示冠状窦。共发现 27 种 CVS 解剖学变异，其中 9 种最常见（199 例中有 148 例；74.4%）。在这 9 种变异中，有 4 种出现了单个 CRT 靶区的冠状静脉，3 种变异出现了 2 个靶静脉，2 种变异出现了 3 个静脉。在 6 例（2 例罕见变异；3.0%）中，未在靶区发现静脉。
在大多数接受检查的患者中，至少可以观察到 CRT 靶区的一条静脉。CVS 的解剖学变异性增强了 MSCT 在 CRT 植入前对 CVS 可视化的潜在作用。
