Aortic Imaging: Your Questions Answered
24:42-27:08
But there are cases where I'll have to go back to my presentation here to show you that one second where there is extreme scenario when the patient comes in and the first thing you see is, is a very enlarged heart like this and the root this is actually, the root of the patient that's very enlarged you can see and the valve that's supporting that root is the aortic valve and see this aortic valve is almost looks like a Mercedes Benz sign. When it closes it is actually leaking. It doesn't close all the way because the root is so enlarged so the person has what we call valve regurgitation. The valve is leaky along with the enlargement of the root and all of the blood is going back into the ventricle. This is one of the complications that happens when the root enlarges due to Marfan is you make, develop what we call aortic regurgitation which as some of you may have heard of.
先ほどのケースとは異なり、画像検査をした段階で、こちらの画像のように心臓も、大動脈基部もかなり大きくなっているケースもあります。大動脈基部を支えている大動脈弁は、メルセデス・ベンツのマークのように見えますが、閉じたときにリークが生じています。基部が大きく拡張しているためにしっかりと閉まらなくなっており、これにより血液が心室へと逆流しています。マルファン症候群の合併症の一つで、大動脈弁逆流と呼ばれています。
And this technique and we have used here used to image is MRI. We not only assess the heart dimension, function, we also assess the dimensions of the root and we also assessed the how severe is that valve leaking before any procedure is done, so all of the surgical planning can be done using this technique here where we measured the dimensions of the heart measured how leaky that valve is using one technique here and we measured the dimensions of the root that's the root this is the left ventricle actually I put a cartoon here the enlarged root is right here so basically all the planning for surgery is done right away using this technique.
お見せしているMRI検査では、心臓の大きさや機能だけではなく、基部のサイズやリークの重症度も調べます。この結果に基づいて手術の計画をします。右下の画像に左室の画像（赤）を付け加えましたが、その上にあるのが拡張した大動脈基部です。
It all depends on what we are trying to achieve when it comes to serial follow-up imaging or is this an acute situation where we have to get all one test before the surgical planning or anything that's planned depends on that and even a dissection to what we're trying to achieve. If the kidney function is affected we may use the trans-esophageal echo. If kidney function is fine we could, CT is the first line of test for dissection if you ask me.
検査結果によって、このまま定期検査となったり、緊急の場合であれば、検査結果のみに基づき、手術などの計画を立てることになります。大動脈解離の場合は、腎機能が良好であれば、CTが第一選択の検査となり、腎機能が障害されている場合には、経食道心エコーを選択することになるでしょう。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
