대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제81권2호
  • /
  • Pages.272-289
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  • 2020
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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좌심방과 좌심방이의 전산화단층촬영 소견: 해부학, 정상변이 및 질환에 관한 임상화보

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology

  • 송민지 (충북대학교병원 영상의학과) ;
  • 김성진 (충북대학교병원 영상의학과) ;
  • 구현정 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 김문영 (서울특별시보라매병원 영상의학과) ;
  • 유진영 (충북대학교병원 영상의학과)
  • Minji Song (Department of Radiology, Chungbuk National University Hospital) ;
  • Sung Jin Kim (Department of Radiology, Chungbuk National University Hospital) ;
  • Hyun Jung Koo (Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Moon Young Kim (Department of Radiology, SMG-SNU Boramae Medical Center) ;
  • Jin Young Yoo (Department of Radiology, Chungbuk National University Hospital)
  • 투고 : 2019.12.24
  • 심사 : 2020.03.19
  • 발행 : 2020.03.01
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초록

전산화단층촬영(이하 CT) 영상 기술의 발전으로 박동하는 심장에 대한 섬세한 영상의학적 평가가 가능해졌다. 심초음파 및 MRI에 비해 심장 CT의 강점은 대부분의 의료기관에 보급되어 있고 고품질 이미지의 빠른 생산이 가능하며 해부학적 묘사가 뛰어나다는 것이다. 좌심방과 좌심방이에서 생기는 대부분의 변이 혹은 병리적 상태들은 CT 상의 소견만으로도 추정 진단을 내릴 수 있다. 또한 CT 영상은 성공적인 카테터 기반 시술 또는 수술에 중요한 해부학적 정보들을 제공한다. 특히 좌심방과 좌심방이는 심방세동 환자들의 치료 및 관리에 중요한데, 이는 다양한 카테터 기반 시술들이 두 구조물의 기계적 혹은 전기적 차단을 목표로 하기 때문이다. 따라서 임상적으로 의미 있는 판독을 위해서는 병리적 상태의 CT 소견 기술과 함께 좌심방 및 좌심방이의 모양, 크기 및 주변 구조물과의 상대적 위치 관계 등에 대한 포괄적인 검토를 해야 한다.

Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

키워드

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