國立臺灣大學醫學院外科邱英世2006-07-262018-07-112006-07-262018-07-112001-12-31http://ntur.lib.ntu.edu.tw//handle/246246/24431大動脈完全轉位在過去半世紀以來 的外科治療史發現右心室無法取代左心室 做為全身循環的幫浦心室。但是為什麼右 心室長成梯形而左心室呈梨形的功能性含 意一直未被提出。我們在本計畫以核磁共 振做研究來推論心室外形與其出口動脈分 枝型態之相關性。 我們以核磁共振造影進行十名正常成 人之心臟顯影，採用未飽和磁場脈衝外加 在梯形右心室下緣之兩個銳角，並定量在 左右肺動脈橫截面呈現之未飽和磁場量。 本研究發現心室外形與其出口動脈分枝型 態有關聯。了解心室外形之功能性含意有 助於判斷矯正型大動脈轉位之病人是否應 該接受雙轉換手術；對右心室已轉變成左 心室外形且三尖瓣功能良好者施行傳統矯 正手術即可。Throughout the surgical history to repair transposition of the great arteries in the past half-century, human has learned that the right ventricle cannot replace the left ventricle as a systemic pumping chamber. The shape of normal right ventricle is totally different from that of left ventricle, trapezoid of the former versus pear-form of the latter. Yet the functional implications of the shape were seldom explained in the past. The pulmonary trunk branches early into right and left pulmonary arteries. While the relatively late-branching of the aorta dictates its pumping chamber to become a pear-shaped left ventricle. We carried out a magnetic resonance imaging study on 10 normal persons, to see whether left lower vertex of the trapezoid right ventricle sends its blood into lower right pulmonary artery, while relatively higher right lower vertex into higher left pulmonary artery. The results showed the shape of ventricles is related with its outgoing arterial branching pattern. This inference is helpful to judge those patients with congenitally corrected transposition is justified to undergo double switch operation according to the shape of ventricles, i.e. those with incomplete transition.application/pdf201766 bytesapplication/pdfzh-TW國立臺灣大學醫學院外科梯形右心室梨形左心室肺動脈 幹提早分枝主動脈較晚分枝大 動脈完全轉位trapezoid right ventriclepear-form left ventricleearly branching pulmonary trunkrelatively late-branching aortaand complete transposition of the great arteriesreporthttp://ntur.lib.ntu.edu.tw/bitstream/246246/24431/1/892314B002283.pdf