Tůma S, Lízler J, Fendrych P, Hruda J, Bartáková H
Klinika zobrazovacích metod, Fakultní nemocnice v Motole, Praha.
Cesk Pediatr. 1993 Nov;48(11):645-7.
The justification of examinations by magnetic resonance and the results of visualization of cardiac and vascular structures in relation to the performed surgical operation were evaluated retrospectively in 24 children after surgery of congenital heart disease. Thirteen patients had an operation of coarctation or a double aortic arch and four had an operation of an anomaly of the branch of the pulmonary artery-its loop or atresia. Seven patients had operations, mostly complicated inborn heart disease, of the common arterial trunk and transposition of the large arteries with a conduit, tricuspidal atresia after Fontan's or Glenn's modified operation and ligature of an aortal aneurysm. At the time of examination the patients were 4 to 18 years old. Spin echo sequences obtained by basic reconstructions of T1 and possibly T2 weighted images on a 1.5 T Magnetom apparatus Siemens proved an excellent visualization in the area of the large arteries and the capacity of detailed visualization of cardiac structures, incl. changes of the vascular wall in relation to the performed operation. Magnetic resonance examinations provided accurate information on central anastomoses and conduits as well as on changes of the vascular lumen. The investigation confirmed that magnetic resonance is suitable for visualization of postoperative changes and findings of morphological structures in particular at sites of cardiovascular anastomoses where magnetic resonance supplements the visualization capacity of echocardiography and substitutes invasive examinations where only an angiographic examination is needed. In eight instances the examination was supplemented by invasive assessment of haemodynamic conditions.
回顾性评估了24例先天性心脏病手术后儿童的磁共振检查的合理性以及心脏和血管结构可视化结果与所进行的外科手术的关系。13例患者接受了缩窄或双主动脉弓手术,4例接受了肺动脉分支异常(其环或闭锁)手术。7例患者接受了手术,主要是复杂的先天性心脏病,包括共同动脉干、大动脉转位并带有导管、Fontan或Glenn改良手术后的三尖瓣闭锁以及主动脉瘤结扎术。检查时患者年龄为4至18岁。在西门子1.5T Magnetom设备上通过T1以及可能的T2加权图像的基本重建获得的自旋回波序列,在大动脉区域显示出极佳的可视化效果,并能够详细显示心脏结构,包括与所进行手术相关的血管壁变化。磁共振检查提供了关于中央吻合口和导管以及血管腔变化的准确信息。该研究证实,磁共振适用于可视化术后变化和形态结构的发现,特别是在心血管吻合部位,磁共振补充了超声心动图的可视化能力,并替代了仅需血管造影检查的侵入性检查。在8例病例中,通过侵入性评估血流动力学状况对检查进行了补充。