Prenatal three-dimensional color Doppler imaging showing crossover of the inflow streams of two ventricles in a case of criss-cross heart

摘要

Criss-cross heart is a rare complex congenital cardiac malformation characterized by crossing of the inflow streams of the ventricles due to twisting of the heart along its long axis [1]. Only a few prenatally diagnosed cases have been reported previously [2, 3, 4].3D color Doppler TUI displayed the inflow streams of the LV and RV simultaneously and separately, which assisted us in understanding the spatial relationship of the atrioventricular connections. Moreover, 3D color Doppler rendering imaging clearly delineated the characteristic crossing of the inflow streams; these are difficult to see with 2D color Doppler because the two AV valves are not visualized on the same plane due to the twisting of the heart [1].Although 3D echocardiography has been implemented, 2D echocardiography is the principal tool for evaluating fetal heart defects [5]. One of the main reasons for this is that the image resolution obtained with a 3D dataset is not as good as that of 2D real-time ultrasound. In this case, 2D echocardiography visualized each atrioventricular inflow tract clearly, but the 2D images required us to create a mental 3D reconstruction of the complexed atrioventricular connections for the diagnosis of criss-cross heart.