Fulcher Ann S, Turner Mary Ann
Department of Radiology, Medical College of Virginia of Virginia Commonwealth University, 401 N 12th St, Rm 3-407B, Richmond, VA 23298-0615, USA.
Radiographics. 2002 Nov-Dec;22(6):1439-56. doi: 10.1148/rg.226025016.
A study was made of 19 adults with situs anomalies (situs inversus [n = 10], situs ambiguous with polysplenia [n = 8], situs ambiguous with asplenia [n = 1]). No patient had congenital heart disease, bowel obstruction related to malrotation, or immune deficiency disorders. All 10 patients with situs inversus had mirror-image location of the abdominal organs relative to situs solitus; nine had dextrocardia, and one had levocardia. The eight adults with situs ambiguous with polysplenia demonstrated a spectrum of abnormalities. All had some degree of abdominal heterotaxy, including midline livers and gallbladders (n = 5), right-sided stomachs and spleens (n = 3), and rotational abnormalities of the small bowel and colon (n = 7). Other findings included multiple spleens (n = 7), interruption of the inferior vena cava (IVC) with azygous or hemiazygous continuation (n = 7), truncation of the pancreas (n = 6), and ipsilateral location of the aorta and IVC (n = 1). In the one patient with asplenia, a midline liver, right-sided stomach, bowel rotation abnormality, IVC interruption, and pancreatic truncation were noted. Recognition of the spectrum of situs anomalies is important because the altered anatomy associated with these anomalies may result in confusing imaging findings when seen in conjunction with acquired diseases.
对19例脏器位置异常的成年人进行了研究（内脏反位[n = 10]、多脾综合征导致的内脏位置不明确[n = 8]、无脾综合征导致的内脏位置不明确[n = 1]）。所有患者均无先天性心脏病、与旋转不良相关的肠梗阻或免疫缺陷疾病。所有10例内脏反位患者的腹部器官位置与正常位置呈镜像关系；9例为右位心，1例为左位心。8例多脾综合征导致内脏位置不明确的成年人表现出一系列异常。所有人都有一定程度的腹部脏器异位，包括中线肝脏和胆囊（n = 5）、右侧胃和脾脏（n = 3）以及小肠和结肠的旋转异常（n = 7）。其他发现包括多个脾脏（n = 7）、下腔静脉中断伴奇静脉或半奇静脉延续（n = 7）、胰腺截断（n = 6）以及主动脉和下腔静脉同侧（n = 1）。在1例无脾综合征患者中，发现有中线肝脏、右侧胃、肠旋转异常、下腔静脉中断和胰腺截断。认识到脏器位置异常的范围很重要，因为与这些异常相关的解剖结构改变在与后天性疾病同时出现时可能导致影像学表现混淆。
