Volume Rendering-Based Phrenic Nerve/Pericardiophrenic Bundle Identification Using Cardiac Computed Tomography.

Daisetsu Aoyama, Mark Rimmer, Yuichiro Miyazaki, Yu Izawa, Tatsuya Nishii, Kalyanam Shivkumar, Shumpei Mori

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Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Daisetsu AoyamaDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles (UCLA), Los Angeles, California, USA.

Mark RimmerDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles (UCLA), Los Angeles, California, USA.

Yuichiro MiyazakiDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles (UCLA), Los Angeles, California, USA.

Yu IzawaDivision of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Tatsuya NishiiDepartment of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Kalyanam ShivkumarDepartment of Medicine, Radiology & Bioengineering, UCLA, Los Angeles, California, USA.

Shumpei MoriDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles (UCLA), Los Angeles, California, USA. Electronic address: smori@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

anatomyPhrenic nerves descend anterior to the pulmonary hila, sandwiched between the pericardium and parietal pleura, thus running extrinsically to the heart and lungs. PATHOLOGY: Phrenic nerve injury during catheter ablation or diaphragmatic stimulation during cardiac resynchronization therapy. IMAGING CORRELATION: Conventional approach of preprocedural identification of the phrenic nerve includes slice-by-slice detection of the pericardiophrenic bundle using axial images. However, it is time-consuming with substantial uncertainty and difficulty in precise structural tracing in each axial plane. Three-dimensional visualization using a volume rendering technique has a distinct advantage for detecting fine structures and their anatomical course. TREATMENT: Preprocedural identification of the 3-dimensional course of the phrenic nerve in relation to surrounding structures is useful in avoiding iatrogenic injury of the phrenic nerve or predicting diaphragmatic stimulation. TAKE-HOME MESSAGE: Volume rendering reconstruction offers fast and easy 3-dimensional identification of the phrenic nerve and is even feasible without a contrast material.

Indexed as

anatomycomputed tomographyphrenic nervevolume rendering

Identifiers

PMID40940115

DOI10.1016/j.jaccas.2025.104947

PMCPMC12789753

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