Stümper O F, Sreeram N, Elzenga N J, Sutherland G R
Department of Cardiology, Erasmus University, Rotterdam, The Netherlands.
J Am Coll Cardiol. 1990 Aug;16(2):442-6. doi: 10.1016/0735-1097(90)90599-k.
In a prospective investigation, direct visualization of both atrial appendages was attempted during transesophageal echocardiographic studies in 132 patients with congenital heart disease. High quality cross-sectional images delineating the unique morphologic details of both atrial appendages were obtained in every patient. Abnormal cardiac position such as dextrocardia (four patients) or mesocardia (two patients) did not pose any problems for transesophageal assessment of both atrial appendages. Thus, direct diagnosis of atrial situs was possible in every patient. Atrial situs solitus was present in 127 patients studied. Three patients were found to have situs inversus, one had left atrial isomerism and one had right atrial isomerism. No patient with juxtaposed atrial appendages was encountered. All patients had prior subcostal ultrasound scans for assessment of the morphology and relation of the suprarenal abdominal great vessels and the related patterns of hepatic venous drainage. Patients with abnormal atrial situs had correlative high kilovoltage filter beam radiography for assessment of bronchus morphology. The results of situs determination obtained by either method were in agreement. In this series, transesophageal echocardiography allowed the direct and accurate visualization of both atrial appendages and the determination of atrial situs in all patients studied. Transesophageal echocardiography may prove to be the most reliable in vivo technique for determination of atrial situs.
在一项前瞻性研究中，对132例先天性心脏病患者进行经食管超声心动图检查时，尝试对双侧心耳进行直接可视化观察。每位患者均获得了描绘双侧心耳独特形态细节的高质量横断面图像。心脏位置异常，如右位心（4例）或中位心（2例），对经食管评估双侧心耳并无任何影响。因此，每位患者均有可能直接诊断心房位置。在接受研究的127例患者中存在正常心房位置。发现3例患者为心房反位，1例为左心房异构，1例为右心房异构。未遇到心耳并列的患者。所有患者均曾接受肋下超声扫描，以评估肾上腺上方腹部大血管的形态及关系以及肝静脉引流的相关模式。心房位置异常的患者接受了相关的高千伏滤线栅X线摄影，以评估支气管形态。两种方法所获得的心房位置判定结果一致。在本系列研究中，经食管超声心动图能够对所有研究患者的双侧心耳进行直接且准确的可视化观察，并确定心房位置。经食管超声心动图可能是确定心房位置最可靠的体内技术。
