Abstract
Aim. To demonstrate the capabilities of magnetic resonance imaging (MRI) and magnetic resonance (MR) angiography in the complex examination of patients with various types of transposition of great arteries (TGA) at the pre- and postoperative stages.Material and Methods. A total of 38 MRI studies of the heart and blood vessels were performed in 33 patients with various forms of transposition of great vessels.Results. The main purpose of MRI was to identify postoperative complications after arterial switch operation for simple TGA. Cicatricial changes in the wall of the left ventricle were revealed in two patients, which was the basis for coronary angiography. Coronary angiography revealed no significant coronary artery stenosis requiring surgical intervention. The aortic root was dilated to an average of + 2.85 Z-score in six patients after arterial switch operation, which required further dynamic observation. Stenosis of the branches of the pulmonary artery due to the use of the Lecompte maneuver was revealed in one patient. Heart catheterization was performed according to the results of MRI. Invasive pressure measurement revealed neither significant stenosis nor indications for surgical treatment. MRI data were used as one of the criteria for anatomical correction readiness in group of patients with congenitally corrected transposition of the great vessels, along with data of echocardiography and heart catheterization.Conclusion. MRI and MR angiography are the “gold standard” in the pre- and postoperative examination of patients with various forms of TGA . Using MR angiography, it is possible to carry out morphometry and clarify the spatial arrangement of vessels including that after correction of TGA. In most cases, MRI allows to correctly differentiate the morphology of the heart chambers and their relative position. It also allows to perform volumetry and to assess the parameters of local and global contractile function of the ventricles, which is essential for preoperative assessment and dynamic observation at all stages of correction.
Highlights
A total of 38 magnetic resonance imaging (MRI) studies of the heart and blood vessels were performed in 33 patients with various forms
Cicatricial changes in the wall of the left ventricle were revealed in two patients
which was the basis for coronary angiography
Summary
В Детской Республиканской клинической больнице Министерства здравоохранения Республики Татарстан в течение 2 лет проведено 38 исследований сердца и сосудов у 33 пациентов с различными формами ТМС методом МРТ. Пациенты с простой транспозицией магистральных сосудов после операции артериального переключения. Визуализация в различных плоскостях в последовательности SSFP дает дополнительную информацию о пространственных соотношениях сердца и окружающих структур на постоперационном этапе наблюдения пациентов с ТМС, особенно при возникновении осложнений (например, при обструкции кондуита). 1. Серия срезов по короткой оси сердца в режиме T1-TSE (а, б, в) и SSFP (г, д, е) пациента с корригированной транспозицией магистральных сосудов. Используя толщину среза 0,8–1 мм, возможно визуализировать анатомию коронарных артерий, а также достаточно точно оценить взаимоотношение камер сердца, магистральных сосудов и септальных дефектов 2. TOF-ангиография с 3D-реконструкцией изображения (е), демонстрирующая аорту и ветви легочной артерии пациента с транспозицией магистральных сосудов после операции артериального переключения с маневром Lecompte Fig. 2. 3. 4-камерная проекция и серия срезов по короткой оси сердца в кинорежиме SSFP (а, б, в, г) пациента с корригированной транспозицией магистральных сосудов, атрезией легочной артерии 1-го типа, дефект межжелудочковой перегородки. Результаты магнитно-резонансной томографии у пациентов с корригированной транспозицией магистральных сосудов
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