Lee Hee-Sun, Kim Hyung-Kwan, Park Eun-Ah, Kim Kyung-Hwan, Kim Yong-Jin, Sohn Dae-Won
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
J Cardiovasc Ultrasound. 2014 Dec;22(4):205-8. doi: 10.4250/jcu.2014.22.4.205. Epub 2014 Dec 26.
Left atrial (LA) dissection is a rare entity, which is, in most cases, observed after valvular intervention. Transesophageal echocardiography (TEE) is considered to be a modality of choice in the diagnosis of LA dissection. However, LA dissection might be missed clinically in the absence of significant hemodynamic changes, and moreover physicians are occasionally reluctant to perform TEE due to its semi-invasiveness. Recently, cardiac magnetic resonance (CMR) has been introduced as a modality to perform different roles to existing imaging modalities, such as echocardiography. Given that CMR can provide information on tissue characteristics, it may give incremental information to TEE. We here present a rare case of LA dissection following LA myxoma removal, where CMR can make a correct diagnosis and guide management strategy.
左心房（LA）夹层是一种罕见的病症，在大多数情况下，是在瓣膜介入术后观察到的。经食管超声心动图（TEE）被认为是诊断LA夹层的首选方式。然而，在没有明显血流动力学变化的情况下，LA夹层在临床上可能会被漏诊，而且由于其具有半侵入性，医生偶尔也不愿意进行TEE检查。最近，心脏磁共振成像（CMR）作为一种成像方式被引入，它能发挥与现有成像方式（如超声心动图）不同的作用。鉴于CMR可以提供组织特征信息，它可能会为TEE提供更多信息。我们在此呈现一例LA黏液瘤切除术后发生LA夹层的罕见病例，CMR在该病例中能够做出正确诊断并指导治疗策略。
