Sakuma I, Mikami T, Kakinoki S, Kanamori K, Kudo T, Sakamoto S, Yasuda H
J Cardiogr. 1983 Sep;13(3):699-713.
X-ray computed tomography (CT) was performed in two patients with complex congenital heart disease in order to assess the clinical utility in the systemic morphological diagnosis. A Somotom 2 whole body CT scanner (Siemens Co) was used, and contrast enhanced CT scanning and a dynamic CT scanning were performed in one case (Case 2).; Case 1: A 20-year-old female with double outlet right ventricle (S, D, L), pulmonary stenosis and aortic insufficiency. The CT revealed a viscero-atrial situs, ventriculoarterial relation, spatial interrelationship between the great arteries and a run of the stenotic pulmonary artery. The CT clarified spatial relationship among four cardiac chambers, ventricular septal defect and great arteries, contributing to the understanding of the complex cardiac structure. Case 2: A 26-year-old female with single ventricle (III-C solitus), pulmonary stenosis, dextroversion, left superior vena cava and WPW syndrome. The CT documented precisely a viscero-atrial situs, dextroversion, ventriculoarterial relation, spatial interrelationship between the great arteries, stenotic main and left pulmonary arteries and a dilated right pulmonary artery due to the right Blalock-Taussig operation performed 15 years before. A diagnosis of left superior vena cava could be made by CT, and its flow into coronary sinus was visualized by dynamic CT. The dynamic CT also clarified a mixing of venous and arterial blood in the common ventricle, and revealed a rudimentary ventricular septum. Thus, the CT serves useful purposes especially as examination of viscero-atrial situs, ventriculoarterial relation and spatial interrelationship between great arteries, and anomalies of the mediastinal vessels. Furthermore the relationship among four cardiac chambers, ventricular septal defect, and the pattern of blood flow were also clarified. However, the CT failed to define the state of a ventricular loop, because it could not identify ventricular muscular structures and atrioventricular valves as these move rather vigorously. The CT could not locate pulmonary stenosis, valvular or somewhere else. The CT seemed to be a promising noninvasive method in the systemic morphological diagnosis of congenital heart disease as subsidiary to echocardiographic investigation. However, in pediatric patients, it seemed considerably hard to obtain clear cardiac CT images because of the difficulty in halting respiration during procedure.
对两名复杂先天性心脏病患者进行了X线计算机断层扫描（CT），以评估其在全身形态学诊断中的临床应用价值。使用了一台Somatom 2全身CT扫描仪（西门子公司），对其中1例患者（病例2）进行了对比增强CT扫描和动态CT扫描。病例1：一名20岁女性，患有右心室双出口（S，D，L型）、肺动脉狭窄和主动脉瓣关闭不全。CT显示了内脏心房位置、心室动脉关系、大动脉之间的空间相互关系以及一段狭窄的肺动脉。CT明确了四个心腔、室间隔缺损和大动脉之间的空间关系，有助于理解复杂的心脏结构。病例2：一名26岁女性，患有单心室（III-C型，孤心型）、肺动脉狭窄、右旋心、左上腔静脉和WPW综合征。CT精确记录了内脏心房位置、右旋心、心室动脉关系、大动脉之间的空间相互关系、狭窄的主肺动脉和左肺动脉以及因15年前进行的右Blalock-Taussig手术导致的右肺动脉扩张。CT可诊断左上腔静脉，并通过动态CT观察到其流入冠状窦的情况。动态CT还明确了共同心室内静脉血和动脉血的混合情况，并显示了一个残存的室间隔。因此，CT尤其在检查内脏心房位置、心室动脉关系、大动脉之间的空间相互关系以及纵隔血管异常方面具有重要作用。此外，四个心腔之间的关系、室间隔缺损和血流模式也得到了明确。然而，CT无法确定心室襻的状态，因为它无法识别心室肌结构和房室瓣，因为这些结构运动较为剧烈。CT无法定位肺动脉狭窄是瓣膜性的还是其他部位的。CT似乎是先天性心脏病全身形态学诊断中有前景的非侵入性方法，可作为超声心动图检查的辅助手段。然而，在儿科患者中，由于检查过程中难以停止呼吸，似乎很难获得清晰的心脏CT图像。
