磁共振成像在心房异构诊断中的应用

目的：评价磁共振成像在心房异构（心脾综合征）中的应用价值。方法：MRI应用于88例心脾综合征检查中，平均年龄3.69岁（1月~15岁），扫描序列包括真稳态进动快速成像序列（FIESTA），双反转恢复序列（double IR），CE-MRA。所有患儿均行心脏超声心动图检查及心血管造影，72例心血管畸形经手术证实。结果：右房异构67例，左房异构21例。右房异构中均为复杂先天性心脏病，支气管均为对称的右支气管形态，双上腔静脉45例（64.3％），肝静脉分支单独连接心房17例，肺静脉异位引流23例，食道裂孔疝2例。左房异构均为对称左主支气管形态，下腔静脉中断经奇静脉延续16例（78.2％）。心外大血管异常诊断符合率100％。结论：MRI既可检出心内及心外大血管的各种复杂畸形，同时又可显示对复杂先天性心脏病病诊断有重要帮助的脾脏及气管的位置及形态，是心脾综合征的理想影像学诊断方法。

Applications of MRI in patients with atrial isomerism

Objective: To evaluate the value of MRI in the patients with atrial isomerism(cardiosplenia syndrome). Methods: Eighty-eight cases with cardiosplenia syndrome(mean age 3.69 years; age range 1 month to 15 years) were evaluated by MRI including FIESTA, double IR and CE-MRA. Results: Right atrial isomerism was seen in 67 cases, all of which were associated with complex congenital heart disease. Bilateral morphologic right bronchi were identified in all of the 67 patients, bilateral superior vena cava in 45 and anomalous pulmonary vein connection in 23. Moreover, anomalous hepatic venous drainage was imaged in 17 and hiatal hernia in 2. Left atrial isomerism was otherwise identified in 21 cases with bilateral morphologic left bronchi. Interruption of inferior vena cava with azygos continuation was present in 16 of 21 cases. Diagnostic accuracy of excardiacvascular anomalies was 100%. Conclusion: MRI can provide accurate diagnosis of complex cardiovascular anomalies as well as status of spleen and bronchus, which is very helpful in diagnosis of complex congential heart disease. The advantages of MRI makes it ideally suited to the evaluation of cardiosplenia syndrome.