Magnetic resonance evaluation of criss-cross heart.
The purpose of this study was to report 18 cases of criss-cross heart and to evaluate the utility of magnetic resonance imaging (MRI) for the determination of atrioventricular segmental situs and atrioventricular alignment in patients with criss-cross heart. From August 1999 to March 2007, 18 consecutive patients with criss-cross heart were studied using a 1.5T MR scanner. Echocardiography and x-ray angiocardiography were performed in all patients and surgery was performed in 12 patients. MR examination resulted in the same diagnosis with x-ray angiocardiography in 94.4% of patients (17 of 18). The visceroatrial situs was solitus in 17 patients with normal left side heart position in 14 and dextrocardia in 3. The visceroatrial situs was inversus in 1 patient with dextrocardia. The atrioventricular connections were concordant in 17 patients and discordant in 1. In all patients, the right ventricle was located superiorly and the left ventricle inferiorly. Criss-cross heart is a rare malformation caused by abnormal rotation of ventricles in the embryo. Diagnosis of criss-cross heart is difficult and MRI was very helpful. MRI allowed clear visualization of the horizontal ventricular septum, the crossing inflow streams, atrioventricular segmental situs, atrioventricular alignment, and other malformations.
Ming
Zhu
Z
Imaging Diagnostic Center, Shanghai Children's Medical Center, 1678 Dongfang Road, Shanghai, 200127, China. zhuming58@vip.sina.com
Yumin
Zhong
Z
D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods; D006325:Heart Atria / Q000002:abnormalities* / Q000601:surgery; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index