Haramati Linda B, Glickstein Julie S, Issenberg Henry J, Haramati Nogah, Crooke Gregory A
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, USA.
Radiographics. 2002 Mar-Apr;22(2):337-47; discussion 348-9. doi: 10.1148/radiographics.22.2.g02mr09337.
To plan effective management of congenital heart disease, one needs the clearest understanding of the anatomy. Although echocardiography and angiography are the dominant imaging modalities in patients with congenital heart disease, magnetic resonance (MR) imaging and computed tomography (CT) are valuable noninvasive adjuncts. MR imaging and CT are effective in demonstrating the complex cardiovascular morphology present in congenital heart disease, especially the extracardiac morphology. In patients with tetralogy of Fallot with complex pulmonary artery anatomy, MR imaging and CT are useful in demonstrating the pulmonary artery anatomy, along with the significant aortopulmonary collateral vessels. In the heterotaxy syndromes, patients often have unusual atriovenous connections. MR imaging allows accurate identification of the hepatic, systemic, and pulmonary veins and their relationships to both atria. CT and MR are the imaging modalities of choice in a patient who is thought to have a vascular ring. Treatment of aortic coarctation is usually performed on the basis of typical clinical and echocardiographic findings. In patients with atypical clinical or echocardiographic findings, MR imaging and CT yield helpful information that can change the treatment plan. The enhanced preoperative understanding of congenital heart disease provided by MR imaging and CT simplifies surgical decision making and consequently may improve outcome.
为了制定有效的先天性心脏病管理方案，需要对解剖结构有最清晰的了解。虽然超声心动图和血管造影是先天性心脏病患者的主要成像方式，但磁共振（MR）成像和计算机断层扫描（CT）是有价值的非侵入性辅助手段。MR成像和CT在显示先天性心脏病中存在的复杂心血管形态方面很有效，尤其是心脏外形态。在法洛四联症且肺动脉解剖结构复杂的患者中，MR成像和CT有助于显示肺动脉解剖结构以及显著的主肺动脉侧支血管。在异构综合征中，患者常常有不寻常的房室连接。MR成像能够准确识别肝静脉、体循环静脉和肺静脉及其与两个心房的关系。CT和MR是疑似血管环患者的首选成像方式。主动脉缩窄的治疗通常基于典型的临床和超声心动图表现进行。在临床或超声心动图表现不典型的患者中，MR成像和CT能提供有助于改变治疗方案的信息。MR成像和CT所提供的对先天性心脏病术前更深入的了解简化了手术决策，从而可能改善治疗结果。
