Radiology Imaging, Diagnostic Imaging, Medical Imaging News, Education, Resources

Transposition of the Greate Vessels (D-type)

• Congenital anomaly which results in two independent circulations existing. 1) Blood returning from body->RV->Blood delivered to body and, 2)Blood returning from lung->LV->Blood delivered to lung

• This circulation pattern is incompatible with life unless there are associated anomalies that permit mixing of the two circulations, e.g., ASD, VSD, or PDA.

Radiographic Features:

• ”Egg-on-side” cardiac contour on plain film with narrow superior mediastinum secondary to hypoplastic thymus (unknown cause) and abnormal relationship of great vessels

• As pulmonary resistance decreases, pulmonary vascularity increases.

• Right heart enlargement

• Pulmonary trunk not visible due to posterior position.

• Therapy: PGE1 is administrated to prevent closure of PDA. This is palliative before surgical correction done

Corrected Transposition (l-type)

• AKA, Congenitally Corrected Transposition of the Great Vessels

• Large vessels and ventricles are transposed to the pulmonary arteries; blood from lungs go to the RV, which is in turn connected to the aorta, which takes blood to the body

• Poor prognosis because of associated cardiac anomalies.

Associations:

• Perimembranous VSD, >50%

• Pulmonic Stenosis, 50%

• Anomaly of Tricuspid Value

• Dextrocardia

Radiographic Features:

• Pulmonary trunk and aorta are not apparent due to posterior position

• LA enlargement

• Abnormal AA contour because of the leftward position of the arch

• Right  pulmonary hilus ele