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已知升主动脉瘤患者经胸超声心动图与计算机断层扫描的可行性及准确性比较

Comparison of feasibility and accuracy of transthoracic echocardiography versus computed tomography in patients with known ascending aortic aneurysm.

作者信息

Tamborini Gloria, Galli Claudia Agnese, Maltagliati Anna, Andreini Daniele, Pontone Gianluca, Quaglia Carlo, Ballerini Giovanni, Pepi Mauro

机构信息

Centro Cardiologico Monzino, IRCCS, Institute of Cardiology, University of Milan, Milan, Italy.

出版信息

Am J Cardiol. 2006 Oct 1;98(7):966-9. doi: 10.1016/j.amjcard.2006.04.043. Epub 2006 Aug 22.

Abstract

Aortic valve diseases, hypertension, and connective tissue disorders may be causes of ascending aortic aneurysms. Aortic enlargement monitoring is essential for surgical timing and for operative design. In this regard, several imaging techniques may have limitations: magnetic resonance is not widespread and is expensive, computed tomography uses radiation, and transesophageal echocardiography is a semi-invasive method. The aim of this study was to analyze the feasibility of transthoracic echocardiography in the evaluation of aortic dimensions and its accuracy in comparison with multidetector computed tomography. In 44 patients with known ascending aortic aneurysms, transthoracic echocardiographic and computed tomographic measurements were obtained and compared at different levels: the annulus, sinuses of Valsalva, sinotubular junction, ascending aorta, and aortic arch. Transthoracic echocardiographic diameters were obtained in all patients, apart from the aortic arch, which was measured in 40 cases. Transthoracic echocardiographic and computed tomographic diameters correlated significantly (p <0.001), with very small SEEs: for the annulus, r = 0.846 (SEE 0.37); for the sinuses of Valsalva, r = 0.967 (SEE 0.35); for the sinotubular junction, r = 0.965 (SEE 0.33); for the ascending aorta, r = 0.976 (SEE 0.41); and for the aortic arch, r = 0.87 (SEE 0.50). In conclusion, transthoracic echocardiography is a feasible and accurate technique for the assessment and follow-up of thoracic aortic diameters in patients with ascending aortic aneurysms.

摘要

主动脉瓣疾病、高血压和结缔组织疾病可能是升主动脉瘤的病因。主动脉扩张监测对于手术时机和手术设计至关重要。在这方面,几种成像技术可能存在局限性:磁共振成像并不普及且费用高昂,计算机断层扫描使用辐射,而经食管超声心动图是一种半侵入性方法。本研究的目的是分析经胸超声心动图在评估主动脉尺寸方面的可行性及其与多排计算机断层扫描相比的准确性。对44例已知升主动脉瘤患者,在不同水平(瓣环、主动脉窦、窦管交界、升主动脉和主动脉弓)进行经胸超声心动图和计算机断层扫描测量并比较。除主动脉弓外,所有患者均获得经胸超声心动图直径,主动脉弓测量了40例。经胸超声心动图和计算机断层扫描直径显著相关(p<0.001),标准误非常小:瓣环r=0.846(标准误0.37);主动脉窦r=0.967(标准误0.35);窦管交界r=0.965(标准误0.33);升主动脉r=0.976(标准误0.41);主动脉弓r=0.87(标准误0.50)。总之,经胸超声心动图是评估和随访升主动脉瘤患者胸主动脉直径的一种可行且准确的技术。

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