Zhang Yu-Qi, Yu Zhi-Qing, Zhong Shu-Wen, Wu Lan-Ping, Chen Guo-Zhen, Zhang Zhi-Fang, Wang Qian
Department of Pediatric Cardiology, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai, China.
Echocardiography. 2010 Aug;27(7):878-84. doi: 10.1111/j.1540-8175.2009.01148.x.
The objective of this study was to analyze the echocardiographic characteristics of juxtaposition of the atrial appendages and to determine its prevalence in children with congenital heart disease. From June 1998 to December 2008, 10,880 children underwent selective angiocardiography, magnetic resonance imaging (MRI), and echocardiography for evaluation of congenital heart disease. Juxtaposition of the atrial appendages was diagnosed based on the results of angiocardiography and MRI; the echocardiographic characteristics of this anomaly were analyzed retrospectively. There were 33 patients diagnosed with juxtaposition of the right atrial appendage (JRAA); no patient was diagnosed with juxtaposition of the left atrial appendage. The prevalence of JRAA in children with congenital heart disease was 0.30%. JRAA and abnormal spatial orientation of the atrial septum were visualized by Doppler echocardiography in 28 cases. In the remaining five cases, three cases with suspected JRAA could not be determined by echocardiography and the diagnosis was missed in two cases. The most common associated anomalies were conotruncal malformations (16 cases with double outlet of the right ventricle, 9 cases with pulmonary atresia, 6 cases with transposition of the great arteries, 1 case with tetralogy of Fallot) and tricuspid malformations (6 cases with tricuspid straddling, 3 cases with tricuspid atresia, 2 cases with tricuspid valve stenosis). Based on the characteristic alteration of the plane of the atrial septum and visualization of the malpositioned right atrial appendage, JRAA can be accurately diagnosed by Doppler echocardiography.
本研究的目的是分析心耳并置的超声心动图特征，并确定其在先天性心脏病患儿中的患病率。1998年6月至2008年12月，10880例儿童接受了选择性心血管造影、磁共振成像（MRI）和超声心动图检查，以评估先天性心脏病。根据心血管造影和MRI结果诊断心耳并置；对该异常的超声心动图特征进行回顾性分析。有33例患者被诊断为右心耳并置（JRAA）；无患者被诊断为左心耳并置。先天性心脏病患儿中JRAA的患病率为0.30%。28例通过多普勒超声心动图观察到JRAA和房间隔异常空间方位。在其余5例中，3例疑似JRAA的病例无法通过超声心动图确定，2例漏诊。最常见的相关畸形是圆锥干畸形（16例右心室双出口、9例肺动脉闭锁、6例大动脉转位、1例法洛四联症）和三尖瓣畸形（6例三尖瓣跨瓣、3例三尖瓣闭锁、2例三尖瓣狭窄）。基于房间隔平面的特征性改变和位置异常的右心耳的可视化，JRAA可通过多普勒超声心动图准确诊断。
