Jander Nikolaus, Minners Jan, Arentz Thomas, Görnandt Lothar, Fürmaier Rudolf, Kalusche Dietrich, Neumann Franz Josef
Herz-Zentrum, Bad Krozingen, Germany.
J Am Soc Echocardiogr. 2005 Jun;18(6):654-9. doi: 10.1016/j.echo.2004.10.002.
Doppler-derived flow velocity measured by transesophageal echocardiography (TEE) may overestimate pulmonary vein stenosis. We hypothesized that combining peak velocity with a stenotic flow pattern improves diagnosis compared with magnetic resonance imaging (MRI).
TEE and MRI were performed in 44 patients 19 +/- 11 months after radiofrequency catheter ablation. Pulmonary vein stenosis was defined by a peak velocity of 110 cm/s or more plus a stenotic flow pattern (turbulence and reduced flow variation) on TEE and a lumen reduction of more than 50% on MRI.
In all, 175 pulmonary veins were studied. MRI showed 7 cases of pulmonary vein stenosis that were correctly identified by TEE. In addition, TEE criteria for pulmonary vein stenosis were met in 4 pulmonary veins that did not show obstruction on MRI. In all, 5 pulmonary veins with normal appearance on MRI had peak velocity of 110 cm/s or more with normal flow pattern.
TEE Doppler measurements can be reliably used to detect or exclude significant pulmonary vein stenosis if the diagnosis is restricted to a combination of elevated peak velocity (> or = 110 cm/s) with turbulence and little flow variation.
经食管超声心动图（TEE）测量的多普勒血流速度可能高估肺静脉狭窄。我们假设与磁共振成像（MRI）相比，将峰值速度与狭窄血流模式相结合可改善诊断。
在44例患者射频导管消融术后19±11个月进行TEE和MRI检查。肺静脉狭窄定义为TEE上峰值速度≥110 cm/s加上狭窄血流模式（湍流和血流变化减少），以及MRI上管腔缩小超过50%。
共研究了175条肺静脉。MRI显示7例肺静脉狭窄被TEE正确识别。此外，4条在MRI上未显示梗阻的肺静脉符合TEE肺静脉狭窄标准。共有5条MRI上外观正常的肺静脉峰值速度≥110 cm/s且血流模式正常。
如果诊断仅限于峰值速度升高（≥110 cm/s）与湍流和血流变化小相结合，TEE多普勒测量可可靠地用于检测或排除明显的肺静脉狭窄。
