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重庆三峡中心医院放射科
重庆市万州区新城路165号 404000
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左心房憩室 left atrial diverticula

左心房憩室 left atrial diverticula

2014-02-25 三峡医院 医学影像

左心房憩室样结构变异有较高的发生率,其可能位于房颤射频消融线区域,也可以是心房内血栓发生区,利用非创伤性CT检查技术、能以三维成像和内镜形式等对心房解剖结构变异进行准确评估,对于射频消融技术术前评估具有重要意义。

Different locations of left atrial diverticula (LAD) in left atrial wall. A, A cystiform LAD in the right anterosuperior wall (short arrow) close to the ostia of the right superior pulmonary vein. Note a tubiform LAD in the right inferior wall of the left atrium (long arrow). B, A cone-shaped LAD in the right anterosuperior wall (long arrow) close to the ostia of the right superior pulmonary vein and a cystiform LAD near the ostia of the left atrial appendage (LAA) (short arrow). C, A cystiform LAD in the left lateral wall (arrow). D, A cystiform LAD in the left inferior wall (arrow) seats closely to the mitral isthmus (dotted line). A sinoatrial nodal artery transverses the mitral isthmus; this artery is susceptible to injury during ablation of the mitral isthmus. E, A cone-shaped LAD in the right inferior wall (arrow) of the left atrium. RSPV indicates right superior pulmonary vein; RIPV, right inferior pulmonary vein; LSPV, left superior pulmonary vein; LIPV, left inferior pulmonary vein; and LA, left atrium.

Left atrial diverticula (LAD) in different shapes. A, A cystiform LAD in the right anterosuperior wall (arrow) close to the ostia of the right superior pulmonary vein (RSPV). B, A cone-shaped LAD in the right anterosuperior wall (arrow) close to the ostia of the RSPV. C, A tubiform LAD in the interatrial septum (white arrow). Incidental finding: left atrium to coronary sinus (CS) fistula (asterisk). D and E, A large and irregular LAD in the right inferior wall (arrow) of the left atrium was found in different patients. F, A tubiform LAD in the right inferior wall (arrow) of the left atrium close to the left inferior pulmonary vein. RA indicates right atrium.

The wall of left atrial diverticula (LAD) is much thinner than that of the left atrium (LA). A and B, The wall of a right anterosuperior LAD (short arrow) is much thinner than that of the adjacent LA (long arrow). RSPV indicates right superior pulmonary vein; LAA, left atrial appendage.

The relationships of left atrial diverticula (LAD) with ablation sites of left pulmonary veins and left atrial appendage (LAA).A through C, Three-dimensional CT reconstructions show that ablation sites (red dotted lines) might fall in the LAD (arrows). D, Virtual endoscopy demonstrates that ablation site (red dotted lines) does not fall in an LAD (arrow). RSPV indicates right superior pulmonary vein; RIPV, right inferior pulmonary vein; and RMPV, right middle pulmonary vein.

Axial CT image (a) and three-dimensional reconstruction (b) demonstrate a lobulated atrial diverticulum (arrows).



Typical appearance of atrial diverticula and accessory appendages in different patients. CT image (a) shows an atrial diverticulum with a broad base and smooth contour (arrow). CT image (b) demonstrates an accessory appendage with an irregular contour and a narrow ostium (arrow).

CT image shows two diverticula (arrows), with anterosuperior and lateral localizations, in the same patient.

CT image demonstrates atrial diverticula (long arrow) and an accessory appendage (short arrow) in the same patient.


重庆三峡中心医院放射科  李国铨

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