Study on imaging characteristics and regularity of adult corrected transpositionof the great arteries in color Doppler echocardiography

HOU Chuan-ju; DENG Dong-an; ZHU Xian-yang; HAN Xiu-min; LIU Jian-li; HU Bin; WANG Qiao-ling

Journal of China Clinic Medical Imaging ›› 2009, Vol. 20 ›› Issue (5) : 309-312.

论著

Study on imaging characteristics and regularity of adult corrected transpositionof the great arteries in color Doppler echocardiography

HOU Chuan-ju1, DENG Dong-an1, ZHU Xian-yang1, HAN Xiu-min1, LIU Jian-li1, HU Bin2, WANG Qiao-ling1

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Abstract

Objective: To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) with adult corrected transposition of the great arteries(CTGA). Methods: Forty patients with adult CTGA were examined by CDE, 35 cases had angiocardiography and 38 cases were proved by surgical operations. Result: Thirty-nine cases were properly diagnosed based on the CDE characteristics with diagnostic accuracy of 97.5%, 1 case was misdiagnosed as complete transposition of the great arteries. The CDE characteristic and regularity of adult CTGA were obvious: ①Apical four-chamber view of two-dimensional echocardiography(2DE) showed atrioventricular discordance in all patients with atrial situs solitus and an L-loop ventricle in SLL and atrial situs inversus and an D-loop ventricle in IDD. ②The two great arteries appeared as two circular echo signals in the parasternal short-axis view, namely, “double circle” sign of 2DE. The type of transposition of the great arteries can be concluded according to the relationship between the two circles. In SLL, the two circles were positioned in the left anterior-right posterior direction and in IDD, they were positioned in the right anterior-left posterior direction. Pulmonary artery stenosis(PS) and pulmonary hypertension(PH) could be distinguished according to the internal diameters of the two circles. In PS, the posterior circle was smaller than the anterior one and in PH, the posterior circle was bigger. ③Color Doppler flow imaging(CDFI) showed unclear shunt flow signals through the interatrial septum or interventricular septum when patients associated with atrial septal defect or ventricular septal defect. In patients associated with atrioventricular valve insufficiency, CDFI showed obvious reflux signals through atrioventricular valve and in those with PS CDFI showed obvious jet flow signals. Conclusions: Adult CTGA has obvious CDE features and regularities. Identification of atrioventricular and ventriculoarterial discordance with 2DE is the key point to diagnose CTGA. Diagnosis of the associated anomalies of CTGA by 2DE is somewhat difficult but is of great clinical value in deciding operation methods.

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Heart defects / congenital / Echocardiography / Doppler / color

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HOU Chuan-ju;DENG Dong-an;ZHU Xian-yang;HAN Xiu-min;LIU Jian-li;HU Bin;WANG Qiao-ling. Study on imaging characteristics and regularity of adult corrected transpositionof the great arteries in color Doppler echocardiography[J]. Journal of China Clinic Medical Imaging. 2009, 20(5): 309-312