PDF(Pubmed)
Abstract：
The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, transthoracic echocardiography (TTE), cardiovascular magnetic resonance (CMR), and cardiac computed tomography (CCT) in the diagnosis, treatment planning, and long-term follow-up of C-TGA. Fetal echocardiography plays a pivotal role in prenatal detection, enabling early intervention strategies. Despite technological advances, the detection rate varies, highlighting the need for improved screening protocols. TTE remains the cornerstone for initial diagnosis, surgical preparation, and postoperative evaluation, providing essential information on cardiac anatomy, ventricular function, and the presence of associated defects. CMR and CCT offer additional value in C-TGA assessment. CMR, free from ionizing radiation, provides detailed anatomical and functional insights from fetal life into adulthood, becoming increasingly important in evaluating complex cardiac structures and post-surgical outcomes. CCT, with its high-resolution imaging, is indispensable in delineating coronary anatomy and vascular structures, particularly when CMR is contraindicated or inconclusive. This review advocates for a comprehensive imaging approach, integrating TTE, CMR, and CCT to enhance diagnostic accuracy, guide therapeutic interventions, and monitor postoperative conditions in C-TGA patients. Such a multimodal strategy is vital for advancing patient care and improving long-term prognoses in this complex congenital heart disease.
摘要：
大动脉的完全转位（C-TGA）是一种先天性心脏异常，其特征是主要动脉的逆转。早期发现和精确管理对于最佳结果至关重要。这篇综述强调了多模态成像的整体作用，包括胎儿超声心动图,经胸超声心动图（TTE），心血管磁共振（CMR），和心脏计算机断层扫描（CCT）的诊断，治疗计划,和C-TGA的长期随访。胎儿超声心动图在产前检测中起着关键作用，启用早期干预策略。尽管技术进步,检测率各不相同，强调需要改进筛查方案。TTE仍然是初步诊断的基石，手术准备,和术后评估，提供心脏解剖的基本信息，心室功能,以及相关缺陷的存在。CMR和CCT在C-TGA评估中提供了额外的价值。CMR,没有电离辐射，提供从胎儿生命到成年期的详细解剖和功能见解，在评估复杂的心脏结构和术后结局方面变得越来越重要。CCT,凭借其高分辨率成像，在描绘冠状动脉解剖结构和血管结构方面是不可或缺的，特别是当CMR禁忌或不确定时。这篇综述提倡全面的成像方法，集成TTE，CMR,和CCT以提高诊断准确性，指导治疗干预措施，并监测C-TGA患者的术后情况。这种多模式策略对于促进这种复杂的先天性心脏病的患者护理和改善长期预后至关重要。
