Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St, Room 2605-E, Loma Linda, CA 92354, USA.
Radiographics. 2011 Oct;31(6):1669-82. doi: 10.1148/rg.316115529.
Radiology plays a crucial role in initial assessment and follow-up of cardiac conduction devices (CCDs). At least 1 million patients in the United States have permanent CCDs, which comprise pacemakers and implantable cardioverter-defibrillators. Chest radiography is unique because it is the only imaging modality that allows evaluation of the physical integrity of CCD leads. As a result, a basic knowledge of the normal and abnormal radiographic appearances of these devices and their various components is important. Radiologists should have a working knowledge of CCD anatomy as well as appropriate positioning and appearance of CCD leads and generators. Acute complications of CCD implantation include dysrhythmia, pneumothorax, perforation of the heart muscle or a vein, heart valve damage, lead damage, inadequate seating of the terminal connector pin, and presence of an air pocket. Chronic complications include twiddler syndrome, lead fracture, damage to the lead insulation, and lead displacement. Radiologists play an important role in management of patients with CCDs by providing vital information about the device, starting immediately after implantation and continuing throughout its duration in the patient. To fulfill this role, radiologists must have a firm understanding of CCDs and their evolving technology.
放射学在心脏传导装置 (CCD) 的初始评估和随访中起着至关重要的作用。美国至少有 100 万名患者拥有永久性 CCD，其中包括起搏器和植入式心脏复律除颤器。胸部 X 线摄影是独特的，因为它是唯一允许评估 CCD 导联物理完整性的成像方式。因此，了解这些设备及其各种组件的正常和异常射线照相表现的基本知识非常重要。放射科医生应该对 CCD 解剖结构以及 CCD 导联和发生器的适当定位和外观有一定的了解。CCD 植入后的急性并发症包括心律失常、气胸、心肌或静脉穿孔、心脏瓣膜损伤、导联损伤、末端连接器销钉的安装不当以及存在气穴。慢性并发症包括扭动综合征、导联断裂、导联绝缘损坏和导联移位。放射科医生通过提供有关设备的重要信息，在患者植入后立即并在其整个期间内发挥着重要作用，从而在管理 CCD 患者方面发挥着重要作用。为了履行这一职责，放射科医生必须对 CCD 及其不断发展的技术有一个坚定的理解。
