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[大动脉转位Mustard矫治术后解剖结构与心室功能的磁共振断层成像评估]

[Assessment with magnetic resonance tomography of anatomy and ventricular function after Mustard correction of transposition of the great arteries].

作者信息

Kaemmerer H, Theissen P, Kaulitz R, Schirg E, Smolarz K, Luhmer I, Lohrmann S, Sechtem U, Hilger H H, Schicha H

机构信息

Abt. für Kinderkardiologie, Medizinische Hochschule Hannover.

出版信息

Z Kardiol. 1992 Apr;81(4):217-25.

PMID:1604925
Abstract

In order to evaluate postoperative sequelae and ventricular function after Mustard-operation in patients with transposition of the great arteries (TGA), 30 patients were assessed by magnetic resonance imaging in EKG-triggered spin-echo (SE) and gradient-echo (GE) technique. Twenty-three patients, aged 4.7 to 15.8 years, had transposition of the great arteries with intact ventricular septum with or without left-ventricular outflow tract obstruction (TGA+IVS +/- SPS). Seven patients aged 9.5 to 21.7 years had transposition of the great arteries with ventricular septal defect (TGA+VSD). Five patients showed a residual baffle leak, one had a pulmonary venous obstruction, five an obstruction at the caval veins, 13 a left-ventricular outflow tract obstruction, and 14 a tricuspid regurgitation. Right-ventricular enddiastolic volume in patients with TGA+VSD (77.0 +/- 25.5 ml/m2) was significantly higher than in patients with TGA+IVS +/- SPS (61.2 +/- 12.0 ml/m2). In TGA+VSD right-ventricular ejection fraction (47.6 +/- 13.0%) was significantly lower than in patients with TGA+IVS +/- SPS (56.7 +/- 10.7%). The ratio of muscle masses of right to left ventricle was 1.8:1 in patients with TGA+IVS +/- SPS and 2.5:1 in patients with TGA+VSD. In conclusion, after Mustard-operation in patients with transposition of the great arteries (TGA) magnetic resonance imaging provides a comprehensive and noninvasive assessment of postoperative sequelae, residuae, and ventricular function and will, therefore, become the method of choice for postoperative evaluation.

摘要

为了评估大动脉转位(TGA)患者Mustard手术后的术后后遗症及心室功能,采用心电图触发自旋回波(SE)和梯度回波(GE)技术对30例患者进行了磁共振成像评估。23例年龄在4.7至15.8岁之间的患者,患有室间隔完整的大动脉转位,伴或不伴有左心室流出道梗阻(TGA + IVS +/- SPS)。7例年龄在9.5至21.7岁之间的患者,患有室间隔缺损的大动脉转位(TGA + VSD)。5例显示有残余挡板漏血,1例有肺静脉梗阻,5例有腔静脉梗阻,13例有左心室流出道梗阻,14例有三尖瓣反流。TGA + VSD患者的右心室舒张末期容积(77.0 +/- 25.5 ml/m²)显著高于TGA + IVS +/- SPS患者(61.2 +/- 12.0 ml/m²)。在TGA + VSD患者中,右心室射血分数(47.6 +/- 13.0%)显著低于TGA + IVS +/- SPS患者(56.7 +/- 10.7%)。TGA + IVS +/- SPS患者右心室与左心室肌肉质量比为1.8:1,TGA + VSD患者为2.5:1。总之,对于大动脉转位(TGA)患者的Mustard手术后,磁共振成像可对术后后遗症、残留病变及心室功能进行全面且无创的评估,因此将成为术后评估的首选方法。

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