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Hearts with twisted atrioventricular connections: findings at MR imaging
1Department of Diagnostic Radiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Insights
Magnetic resonance imaging aids in diagnosing congenital heart defects like crisscross hearts and superoinferior ventricles. These conditions involve twisted atrioventricular connections, identified by distorted connections and non-parallel valve axes on serial MR images.
Area of Science:
- Cardiology
- Medical Imaging
- Pediatric Cardiology
Background:
- Crisscross heart and superoinferior ventricles are related congenital cardiac malformations.
- These conditions are characterized by abnormal, twisted atrioventricular connections.
- Accurate diagnosis is crucial for appropriate management of these complex heart defects.
Purpose of the Study:
- To investigate the morphologic characteristics of hearts with twisted atrioventricular connections using magnetic resonance (MR) imaging.
- To identify key diagnostic features of these congenital cardiac malformations on MR images.
- To evaluate the utility of MR imaging in the precise diagnosis of twisted atrioventricular connections.
Main Methods:
- Retrospective analysis of three cases with twisted atrioventricular connections.
- Detailed morphologic assessment of cardiac structures using serial magnetic resonance (MR) images.
- Evaluation of atrioventricular connections, cardiac chamber morphology, septal configurations, and great arterial relationships.
Main Results:
- Distorted atrioventricular connections were the most significant diagnostic clue.
- The axes of the atrioventricular connections through the atrioventricular valves were not parallel.
- Unusual chamber recesses, angulated septa, and atypical great arterial relationships supported the diagnosis.
Conclusions:
- Magnetic resonance (MR) imaging is highly effective for diagnosing hearts with twisted atrioventricular connections.
- Specific morphologic features on MR imaging, including distorted connections and non-parallel valve axes, are key indicators.
- Precise morphologic diagnosis of these complex congenital heart defects is achievable with MR imaging.
Abstract:
The "crisscross" heart and the heart with "superoinferior ventricles" are closely related congenital cardiac malformations that are characterized by twisted atrioventricular connections. The authors studied the morphologic characteristics of three hearts with twisted atrioventricular connections as seen on magnetic resonance (MR) images. The most important clue to the diagnosis was the distorted atrioventricular connections that were demonstrated on serial images. The axes of the atrioventricular connections through the atrioventricular valves were not parallel to each other. The presence of unusual recesses in the cardiac chambers, the angulated or curved configuration of the atrial and ventricular septa, and the unexpected great arterial relationship for the given combination of segmental connections supported the findings of twisted atrioventricular connections. MR imaging facilitated the precise morphologic diagnosis of these hearts.