Guit G L, Kroon H M, Chin J G, Pauwels E K, van Voorthuisen A E
Radiology. 1985 Nov;157(2):521-7. doi: 10.1148/radiology.157.2.4048462.
Congenitally corrected transposition (CCT) of the great vessels is an uncommon anomaly usually detected in children because of associated severe cardiac malformations. When these are absent, patients may be hemodynamically normal, but associated cardiac abnormalities are usually present in CCT, leading to symptoms in adulthood. When CCT is suggested in an adult, diagnosis by means of ultrasound may be difficult. Radionuclide angiocardiography (RA) is a simple, noninvasive method by which to diagnose CCT. We found consistent morphologic scintigraphic results in 13 patients with proved CCT, leading to establishment of reliable diagnostic criteria. In all instances of situs solitus the aorta ascends and descends on the left with vertical orientation. In the case of situs inversus, the aorta ascends and descends on the right with vertical orientation. Our criteria are independent of the situs and cardiac position, unlike earlier reports by others. We believe images obtained in the anterior projection are sufficient for the study. The practical application of RA study in patient diagnosis is demonstrated, giving special attention to patients referred because of situs solitus and dextrocardia, in which CCT is known to be present in 50% of cases.
先天性矫正型大动脉转位（CCT）是一种罕见的异常情况，通常因伴有严重心脏畸形而在儿童期被发现。若不存在这些严重心脏畸形，患者的血流动力学可能正常，但CCT患者通常伴有心脏异常，这些异常会在成年期引发症状。当在成年人中怀疑有CCT时，通过超声进行诊断可能会有困难。放射性核素心血管造影（RA）是一种诊断CCT的简单、无创方法。我们在13例经证实的CCT患者中发现了一致的形态学闪烁扫描结果，从而确立了可靠的诊断标准。在所有内脏正位的情况下，主动脉在左侧垂直走行，有升有降。在内脏反位的情况下，主动脉在右侧垂直走行，有升有降。与其他人早期的报告不同，我们的标准与内脏位置和心脏位置无关。我们认为在前位投照中获得的图像足以进行该项研究。文中展示了RA研究在患者诊断中的实际应用，特别关注因内脏正位和右位心而转诊的患者，已知在这些患者中50%的病例存在CCT。
