CAJ | 학술논문

目的探讨十字交叉心(CCH)畸形的房室连接及房室节段空间位置特征,评价超声心动图的诊断价值.方法依据三节段诊断方法,分析10例CCH的超声心动图声像学特征,并与心血管造影、多排CT或磁共振成像对比.结果 10例患者超声心动图均显示左有心室流入道呈交叉关系,阳性率和特异性为100%.室间隔晕水平位9例,矢状位1例.心房正位8例,反位1例,左房对称1例;心室右袢8例,左袢2例.房窜连接一致8例,三节段组合{S.D.L}5例,{S.D.D}、{S.D.S}和{S.L D}各1例;房窒连接不一致和不定各1例,三节段为别{I.D.D}和{A.I.L}.房室连接与房室节段空间位置不一致1例,其房室节段组合为{S.L},而非正常的{S.D}.心室大动脉连接一致1例,不一致9例,其中完全件大动脉转位2例,矫正性大动脉转位1例,有室双出口6例.结论 CCH超声心动图特征为左右室流人道旱交叉关系,室间隔呈水平位.剑下长轴或心尖四腔心切面动态系统扫描是诊断的关键.其房窜连接及房窒节段空间位置非常复杂,有时两者不一致,应分别阐述.
목적 탐토십자교차심(CCH)기형적방실련접급방실절단공간위치특정,평개초성심동도적진단개치.방법 의거삼절단진단방법,분석10례CCH적초성심동도성상학특정,병여심혈관조영、다배CT혹자공진성상대비.결과 10례환자초성심동도균현시좌유심실류입도정교차관계,양성솔화특이성위100%.실간격훈수평위9례,시상위1례.심방정위8례,반위1례,좌방대칭1례;심실우번8례,좌번2례.방찬련접일치8례,삼절단조합{S.D.L}5례,{S.D.D}、{S.D.S}화{S.L D}각1례;방질련접불일치화불정각1례,삼절단위별{I.D.D}화{A.I.L}.방실련접여방실절단공간위치불일치1례,기방실절단조합위{S.L},이비정상적{S.D}.심실대동맥련접일치1례,불일치9례,기중완전건대동맥전위2례,교정성대동맥전위1례,유실쌍출구6례.결론 CCH초성심동도특정위좌우실류인도한교차관계,실간격정수평위.검하장축혹심첨사강심절면동태계통소묘시진단적관건.기방찬련접급방질절단공간위치비상복잡,유시량자불일치,응분별천술.
Objective To explore atrioventricular connection and atrioventricular segmental situs in patients with crisscross heart (CCH) and to evaluate the diagnostic value of echocardiography for this anomaly. Methods Ten consecutive patients with crisscross heart were enrolled into this retrospective study. Their echocardiographic data were analyzed and compared with the results of X-ray angiocardiography and 64-slice multi-detector row computed tomography (MDCT) or MRI. Results The crossing of atrioventricular valves could be seen in each case by scanning in a subxiphoid or apical 4-chamber view. Both the positive rate and the specificity were 100%. Horizontal ventricular septum was in 9 cases and vertical (sagittal) ventricular septum in 1 case. The segmental set of 8 patients with concordant atrioventricular connection was {S. D. L} in 5 cases, {S. D. D} 1 case, {S. D. S} 1 case and {S. L. D} 1 case. The segmental set of 1 case with discordant atrioventricular connection was {I. D. D} and another 1 case with ambiguous atrioventricular connection was {A. L. L}. In 1 case, the atrioventricular connection was inconsistent with the atrioventricular segmental situs. Ventriculoarterial connections were concordant in 1, DORV in 6, TGA in 2 and C-TGA in 1. Conclusion Echocardiography is proven quite helpful in diagnosis of CCH, and continuous sweeps in subxiphoid long-axis plane or apical 4-chamber view play a key role. Both the atrioventricular connection and the atrioventricular segmental situs are complicated so that they are not always concordance with each other. It is necessary to account for separately.