十字交叉心的MRI诊断

MRI diagnosis of criss-cross heart

目的探讨十字交叉心(CCH)在 MR 平扫及增强血管成像(MRA)的影像特点及其诊断价值。方法对4例 CCH 的患者行 MR 检查,按照节段分析的方法和思路,多序列多角度多体位成像,充分显示 CCH 的解剖畸形。结果所有心脏球室袢和内脏-心房位置关系均相适应。4例形态学右心室位于形态学左心室之上,水平室间隔,合并巨大室间隔缺损。2组房室瓣均呈前上-后下垂直排列,两心室流入道血流在空间位置上呈十字交叉。心室-大动脉连接关系异常,完全性大动脉错位1例;右室双出口3例。此外,3例合并肺动脉瓣及瓣下狭窄;1例合并肺动脉高压;1例并存房间隔缺损;1例右位主动脉弓及降主动脉。结论 MRI 诊断 CCH 具有很高的准确性,有重要的临床应用价值。

Objective To investigate the value of MRI and MRA in the diagnosis of criss-cross heart（CCH）. Methods Four eases diagnosed as CCH received MRI examination. According to the methods and considerations of segmental analysis, the scan was performed with multiple sequences, multiple angles, and multiple positions in order to show the complicated anatomical malformations of CCH. Results In all patients, atrioventricular connection was concordant. Both atrioventricular valves were aligned vertically from the anterior-superior to the posterior-inferior position in four patients. The blood streams in the inlet of both ventricles crossed in the midheart. The morphologic right ventricle was superiorly positioned on the morphologic left ventricle. There was horizontal ventricular septum and huge VSD in all patients. The ventriculoarterial connections were discordant, including total transposition of great arteries in 1 patient and double-outlet right ventricle in 3 patients. In addition, associated anomalies were found, including pulmonary stenosis （ n = 3 ） , pulmonary hypertension （ n = 1 ） , ASD （ n = 1 ） , and right aortic arch and decending aorta （ n = 1 ）. Conclusions CCH can be accurately diagnosed by using MRI, and MRI has important value in clinical application.