Unit of Noninvasive Cardiovascular Diagnostics, Upper-Silesian Medical Centre, Katowice, Poland.
Cardiol J. 2011;18(2):146-50.
Multi-slice computed tomography (MSCT) can be used to visualize the anatomy of the coronary venous system (CVS). A pre-procedural evaluation of target veins is a very important element of cardiac resynchronization. Thus, the quality of visualization of the CVS is of great importance. The aim of this study was to analyze the quality of visualization of CVS in MSCT.
In 220 subjects (129 male, average age 57.2 ± 11.8 years), a 64-slice CT (Aquilion 64, Toshiba, Japan) was performed. A scan with ECG-gating was performed using a slice thickness of 0.5 mm during a breath-hold. In each case, 3D volume rendering and 2D MPR reconstructions were created (Vitrea 2). The quality of visualization was graded independently by two cardiologists and a radiologist trained in MSCT on a 0-5 points scale for the coronary sinus and main veins [0 = not visible (lack of vein); 5 = visible as a smoothly bordered vascular structure].
The best visualization of the CVS was obtained for coronary sinus (4.10 ± 1.08), the worst for antero-lateral vein (2.11 ± 1.10). The average number of visible veins was 3.2 per case. Statistically, more veins were visible in older subjects - in the group aged 60+ the average number of visible veins was 3.6 ± 1.1 per case, whereas in those aged under 60 it was 2.9 ± 1.2 (p = 0.0001). There were no statistical gender differences in the quality of CVS visualization.
The target veins for cardiac resynchronization therapy should be the lateral and postero-lateral, which are usually well visible. Such a strategy could increase the usefulness of MSCT.
多层螺旋计算机断层扫描（MSCT）可用于显示冠状静脉系统（CVS）的解剖结构。对靶静脉进行术前评估是心脏再同步治疗的一个非常重要的环节。因此，CVS 的可视化质量非常重要。本研究旨在分析 MSCT 中 CVS 的可视化质量。
在 220 名受试者（129 名男性，平均年龄 57.2±11.8 岁）中，进行了 64 层 CT（Aquilion 64，东芝，日本）检查。使用心电门控技术，在屏气时进行扫描，层厚为 0.5 毫米。在每种情况下，均创建了 3D 容积再现和 2D MPR 重建（Vitrea 2）。两名心脏病专家和一名接受过 MSCT 培训的放射科医生独立对冠状动脉窦和主要静脉的可视化质量进行评分，评分为 0-5 分制[0=不可见（缺乏静脉）；5=可见为平滑边界的血管结构]。
CVS 的最佳可视化效果是冠状动脉窦（4.10±1.08），最差的是前外侧静脉（2.11±1.10）。平均每例可见静脉 3.2 条。统计学上，年龄较大的患者可见静脉较多——60 岁以上组平均每例可见静脉 3.6±1.1 条，而 60 岁以下组平均每例可见静脉 2.9±1.2 条（p=0.0001）。CVS 可视化质量在性别方面无统计学差异。
心脏再同步治疗的靶静脉应为外侧和后侧静脉，这些静脉通常可见度较好。这种策略可以提高 MSCT 的实用性。
