摘要
目的：评价磁共振在先天性心脏病术后随访中的应用价值。方法：MRI应用于96例先天性心脏病术后检查中，平均年龄5.71岁（5天~24岁），姑息术后64例，根治术后32例，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），相位流速编码技术（PC-MRI），CE-MRA。结果：96例中MRI诊断18处ECHO未显示或显示不清的残余心外大血管解剖畸形及吻合口狭窄。23例腔肺吻合（Glenn）术后中5例奇静脉扩张，PC-MRI测得奇静脉内血流为逆向血流。5例全腔肺吻合（Fontan）术后2例血流动力学等效于Glenn术后。5例TOF根治术后中3例肺动脉轻－中度返流，2例重度返流，2例左右肺动脉血流比严重失调。7例完全性肺静脉异位引流（TAPVC）术后吻合口狭窄3例，其中一支肺静脉严重狭窄的患儿中，PC-MRI测得同侧肺动脉流速降低，舒张期反向血流。结论：心脏MRI除了能提供任一平面清晰的心血管解剖图像，结合电影序列及相位编码技术还能提供全面的心功能及血液动力学信息，是先天性心脏病术后随访中的理想影像学诊断方法。
Abstract
Objective: To evaluate the value of MRI in the follow-up of patients with repaired congenital heart disease. Methods: Ninty-six cases with repaired congenital heart disease(mean age 5.71 years; age range 5 days to 24 years) were evaluated by cardiac MRI including FIESTA, double IR, phase-constrast cine imaging and CE-MRA. Thirty-two of the 96 cases underwent corrected repair and 64 had palliated operation. Results: Of the 96 cases, 21 residual excardiac anomalies and anastomosis narrowing, which was missed or not clearly visualized by echocardiography, was detected by MRI. Dilated azygos vein with retrograde flow was found in 5 of 23 cases after bidirectional Glenn operation. In 2 of 5 cases with Fontan operation, hemdynamics measured by PC-MR showed the similar physiology as that of post-Glenn surgery. Varied amount of pulmonary regurgitation occurred in all of the 5 cases with corrected TOF repair. Of the 7 cases after repaired TAPVC, 3 cases with residual pulmonary vein stenosis was found. Decreased systolic velocity and reversed flow during diastolic phase in the ipsilateral branch pulmonary artery with branch pulmonary vein stenosis was measured by PC-MRI in 1 case. Conclusion: MRI can provide high resolution, high contrast, and anatomical images in freely selectable 2D planes. Anatomical images, combined with the functional information provided by cine, velocity-mapping techniques make MRI ideally suited to the evaluation of congenital heart disease in patients after operation.
关键词
心脏病 /
磁共振成像
Key words
Heart diseases /
Magnetic resonance imaging
孙爱敏;朱 铭;钟玉敏;王 谦.
磁共振在先天性心脏病术后随访中的应用[J]. 中国临床医学影像杂志. 2008, 19(4): 235-238
SUN Ai-min;ZHU Ming;ZHONG Yu-min;WANG Qian.
Applications of cardiac MRI after repair of congenital heart disease[J]. Journal of China Clinic Medical Imaging. 2008, 19(4): 235-238
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
