PMC5173494_01
Plain axial image of the thoracic cage. Axial image showing thoracic cage compression observed as a shortening of the anteroposterior diameter of the chest. The ratio of transverse-to-anteroposterior diameter is 3.82.
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The DSCT findings ruled out the possibility of any congenital heart diseases, whereas the axial images clearly showed a markedly shortened anteroposterior diameter of the chest (Fig. 1), which led us to a diagnosis of straight back syndrome.
Volume-rendered images of the thoracic cage. A vertically oriented "pancake" appearance of the heart (A) and a straight vertebral column (B) are shown. Ao: ascending aorta, ICV: inferior caval vein, LA: left atrium, LAA: left atrial appendage, LV: left ventricle, LVOT: left ventricular outflow tract, PA: pulmonary artery, RAA: right atrial appendage, RV: right ventricle, RVOT: right ventricular outflow tract, SCV: superior caval vein, SV: sinus of Valsalva
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A vertically oriented "pancake" appearance (a compressed heart that appears to be enlarged in frontal images) of the heart located in the so-called Valentine position (the heart positioned on its apex) (Fig. 2A), straight vertebral column (Fig. 2B), and compression of the entire right ventricular outflow tract (RVOT) (Figure 3, 4) were clearly demonstrated on the reconstructed images.
Compression of the right ventricular outflow tract: Virtual dissection images. Compression of the entire right ventricular outflow tract (RVOT) between the aortic root and sternum are shown in the multiplanar reconstruction image (A) and volume-rendered image viewed from the cranial (B) and right (C) directions. The sectional plane of panel A is on the same level as that of panel B. The anteroposterior diameter (red arrowheads) of the RVOT is 11.6 mm in systole. AS: atrial septum, CS: coronary sinus, DAo: descending aorta, L: left coronary aortic sinus, LA: left atrium, LAA: left atrial appendage, LAD: left anterior descending artery, LCx: left circumflex artery, LIPV: left inferior pulmonary vein, LMT: left main trunk, MB: moderator band, MVA: mitral valvular attachment, N: non-adjacent aortic sinus, R: right coronary aortic sinus, RA: right atrium, RCA: right coronary artery, RIPV: right inferior pulmonary vein, SPT: septoparietal trabecula, TVA: tricuspid valvular attachment
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A vertically oriented "pancake" appearance (a compressed heart that appears to be enlarged in frontal images) of the heart located in the so-called Valentine position (the heart positioned on its apex) (Fig. 2A), straight vertebral column (Fig. 2B), and compression of the entire right ventricular outflow tract (RVOT) (Figure 3, 4) were clearly demonstrated on the reconstructed images.
Compression of the right ventricular outflow tract: Dye-cast images. The relationship between the sternum and right ventricular outflow tract is shown in the frontal image (A). Viewed from the left posterior oblique 120 , the three-dimensional aspect of the entirely compressed right ventricular outflow tract (yellow dotted circle) between the sternum and aortic root is observed (B). The ascending aorta, aortic root, and left ventricle are removed from panel B (C). Note the aortic "imprint" on the posterior right ventricular outflow tract. LV: left ventricle, RA: right atrium, RAA: right atrial appendage, RV: right ventricle
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A vertically oriented "pancake" appearance (a compressed heart that appears to be enlarged in frontal images) of the heart located in the so-called Valentine position (the heart positioned on its apex) (Fig. 2A), straight vertebral column (Fig. 2B), and compression of the entire right ventricular outflow tract (RVOT) (Figure 3, 4) were clearly demonstrated on the reconstructed images.