Aneurysm of the Left Atrium: Detection by Using Multidetector-Row Computed Tomography Imaging

左心房動脈瘤多切面電腦斷層影像及其臨床意義

李政君(Cheng-Chun Lee) ； 陳志強(Chee-Chiang Chen)

《童綜合醫學雜誌》 4卷2期 (2010/12) Pp. 83-88

https://doi.org/10.29838/TMJ.201012.0006

摘要

左心房動脈瘤是一個罕見的疾病，大多是由左心耳處形成。患有左心房動脈瘤的病患臨床上可能會發生血栓、栓子或是心律不整等併發症。這也是為何許多文獻建議這類疾病需要進行積極治療的原因。近幾年來，多切面電腦斷層在心臟影像方面有了長足的進步。可以應用於評估冠狀動脈、心臟瓣膜、缺血性心臟病之後的心肌存活或是心臟壁運動的種種變化，甚至複雜的小兒先天心臟異常以及心臟手術的術後追蹤等等…。多切面電腦斷層都扮演著愈來愈重要的角色。這篇文章裡報告了兩個左心房動脈瘤病例的多切面電腦斷層的原始橫切面影像以及經由工作站重組之後的立體影像。這兩個病例的左心房動脈瘤皆位於左心房的右下方，與過去文獻所報告的案例不同。重組的心臟立體影像可以由心臟內部及心臟外部觀察左心房動脈瘤與左心房及鄰近大血管的關係，幫忙外科醫師或介入性心臟科醫師做治療上更精確的評估。

關鍵字

動脈瘤 ； 左心房 ； 多切面電腦斷層

並列摘要

Left atrial aneurysms are quite rare and usually develop from the left atrial appendage. Life-threatening complications including intracardiac thrombus, embolism and arrhythmia may occur in these patients, which is why surgical intervention has been recommended by various authors. Application of multidetector-row computed tomography (MDCT) in cardiac imaging has become popular in recent years. It can be used in the evaluation of coronary artery, myocardial viability, myocardial perfusion, cardiac wall motion and heart valves. In the field of cardiac surgery follow-up and complex congenital heart disease, MDCT also plays an important role. Two patients are presented here with left atrial aneurysms involving the right lower portion of the left atrial walls which were diagnosed with multidetector-row computed tomography and post-processing imaging. Virtual endocardioscopy was performed to help interventional cardiologists in assessing the possibility of percutaneous closure of the left atrial aneurysm. 3D volume rendered images further clarifying the spatial relationship between an aneurysm and adjacent structures, thereby facilitating surgical planning.

並列關鍵字

Aneurysm ； left Atrium ； multidetector-row computed tomography ； MDCT