The imaging features of interventricular membranous septal aneurysm based on coronary artery CT angiography and three-dimensional reconstruction technology
Li Zihao, Zhang Hongwei, Xie Bingkun, Qin Xindong, Yu Lina
Department of Radiology, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People's Hospital), Dezhou 253000, China
Abstract：Objective To explore the imaging features and clinical importance of interventricular membranous septal aneurysm (IVMSA) based on coronary artery computed tomography angiography (CTA) and 3D reconstruction technique. Methods This study is a cross-sectional study. Fifty patients with IVMSA who were diagnosed by coronary CTA in the radiology department of Dezhou Hospital, Qilu Hospital of Shandong University from January 2013 to May 2022 were included. The patients comprised 15 males and 35 females aged 35-80 (59±11) years. First, the position of the ventricular septal membrane was found on the 2D axial CTA image of the coronary artery. Then, the CT imaging features of IVMSA in terms of morphology, size, bulging direction, aneurysm wall, and aneurysm cavity thrombosis were analyzed using volume rendering (VR), multiplanar reconstruction (MPR), maximum density projection (MIP), and other post-processing techniques. Results (1) Morphology of IVMSA: The 50 IVMSA cases were divided into three types in terms of morphology. Forty-seven cases were multi-lobed and had uneven leaf size. Two cases were hemispherical, in which the surface was smooth, and the diameter of the aneurysm neck was larger than that of the aneurysm body. One case had a tunnel-like morphology with a long curved aneurysm cavity, which was free in the right ventricle. The aneurysm length and diameter exceeded the aneurysm neck diameter by four times. (2) Size of IVMSA: The diameter of the aneurysm neck was 1.95-18.95 (8.36±3.84) mm, and the length and diameter of the aneurysm body were 2.39-20.70 (9.67±3.77) mm. (3) Bulging direction of IVMSA: IVMSA bulged to the right ventricular inflow tract in 49 patients, and one case bulged to the right ventricular outflow tract. (4) Wall of IVMSA: One patient with ventricular septal defect repair had IVMSA wall rupture, and the other 49 patients showed no signs of aneurysm wall rupture. (5) Cavity of IVMSA: All patients had no thrombosis in the IVMSA cavity. Conclusion IVMSA is multi-lobed with different sizes. Most IVMSA cases bulged into the right ventricular inflow tract, and few IVMSA cases can rupture the aneurysm wall. Thrombosis in the aneurysm cavity is rare. Coronary CTA combined with 3D reconstruction technology can comprehensively observe IVMSA and provide a reliable basis for clinical diagnosis and treatment.
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Li Zihao, Zhang Hongwei, Xie Bingkun, Qin Xindong, Yu Lina. The imaging features of interventricular membranous septal aneurysm based on coronary artery CT angiography and three-dimensional reconstruction technology. Chinese Journal of Anatomy and Clinics, 2023, 28(2): 83-87.
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2023, Vol. 28 
