Department of Radiology, Selcuklu Medical Faculty, Selcuk University, The Central Campus, 42075 Konya, Turkey.
Eur J Radiol. 2012 Jul;81(7):1575-80. doi: 10.1016/j.ejrad.2011.04.060. Epub 2011 May 17.
The left atrial appendage (LAA) is usually known as a long, tubular, hooked structure derived from the left atrium. However, it varies widely in terms of anatomical shape. In this study, anatomical shape variations of the LAA were investigated and classified in vivo in a large group of patients by multidetector computed tomography (MDCT) coronary angiography.
The study included 320 consecutive patients (223 men and 97 women, with a mean age of 58 years) who underwent MDCT coronary angiography. MDCT was performed with a 64-detector-row computed tomographic scanner. LAA anatomical variations were classified as five main types and further divided into subtypes. In addition, we gave the classifications descriptive names according to the anatomical external appearance of the LAA: horseshoe (type 1), hand-finger (type 2a), fan (type 2b), wing (type 2c), hook (type 3), wedge (type 4) and swan (type 5) shapes. The types and subtypes of the LAA variations and the presence of thrombus were recorded.
In our study, the LAA tip orientation was used and the LAA was divided into type 1, type 2a, 2b, 2c, type 3, type 4 and type 5 in 44 (13.8%), 65 (20.3%), 155 (48.4%), 8 (2.5%), 27 (8.4%), 6 (1.9%) and 15 (4.7%) patients, respectively. LAA thrombus was detected in four patients (1.25%), who had classified LAA shapes of type 2a and type 2b.
The LAA has multiple anatomical shape variations. We demonstrated previously undefined new shape types of LAA. Knowledge of LAA variations is important in order to avoid procedure-related complications when ablative treatment is to be performed or if surgical procedures are indicated in this region. MDCT coronary angiography provides important and detailed information about determining and evaluating these variations before undertaking a planned procedure in this region.
左心耳（LAA）通常被认为是一种源自左心房的长管状钩状结构。然而，它在解剖形状上存在很大的差异。本研究通过多排螺旋 CT（MDCT）冠状动脉造影对 LAA 的解剖形状变异进行了体内研究和分类。
本研究纳入了 320 例连续患者（223 例男性，97 例女性，平均年龄 58 岁），均行 MDCT 冠状动脉造影。MDCT 采用 64 排螺旋 CT 扫描仪进行。根据 5 种主要类型和进一步分为亚型对 LAA 解剖变异进行分类。此外，我们根据 LAA 的解剖外观给分类起了描述性的名字：马蹄铁形（1 型）、手形（2a 型）、扇形（2b 型）、翼形（2c 型）、钩形（3 型）、楔形（4 型）和天鹅形（5 型）。记录 LAA 变异的类型和亚型以及血栓的存在。
在我们的研究中，我们使用 LAA 尖端方向，并将 LAA 分为 1 型、2a 型、2b 型、2c 型、3 型、4 型和 5 型，分别在 44 例（13.8%）、65 例（20.3%）、155 例（48.4%）、8 例（2.5%）、27 例（8.4%）、6 例（1.9%）和 15 例（4.7%）患者中发现。4 例（1.25%）患者发现 LAA 血栓，LAA 形状分别为 2a 型和 2b 型。
LAA 有多种解剖形状变异。我们展示了以前未定义的 LAA 新形状类型。了解 LAA 变异对于避免在该区域进行消融治疗或手术时的程序相关并发症非常重要。MDCT 冠状动脉造影在该区域计划进行手术前提供了关于确定和评估这些变异的重要详细信息。
