Hussain Syed I, Gilkeson Robert C, Suarez Jose I, Tarr Robert, Schluchter Mark, Landis Dennis M D, Zaidat Osama O
Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, Milwaukee, Wisconsin 55326, USA.
J Stroke Cerebrovasc Dis. 2008 May-Jun;17(3):134-40. doi: 10.1016/j.jstrokecerebrovasdis.2007.12.008.
The aim of this study was to compare transesophageal echocardiography (TEE) and cardiac-gated computerized tomography (CGCT) in detecting aortic atherosclerosis (AA).
There is evidence that AA can be a source of embolic material causing ischemic stroke. TEE is a well-established tool for detecting cardiac sources of emboli in patients with stroke, but it has distinct limitations in the detection of AA.
This was a prospective study of patients admitted with the diagnosis of ischemic stroke between February and November of 2000. Among this cohort are patients who underwent both TEE and CGCT for the evaluation of stroke cause. The CGCT studies were retrieved and interpreted by a radiologist with special expertise in chest tomography, and TEE studies were read by an echocardiographer with special expertise in reading and performing TEE. The interpreters were unaware of the results obtained by the other. The AA was estimated by measuring atheroma thickness in millimeters. The relations between the two tests were analyzed graphically using Bland-Altman, and Pollock plots. Results from Pearson (r), Spearman (r(s)), and intraclass correlation tests were also estimated.
The aortic atheroma thickness in millimeters was compared between CGCT and TEE in 32 patients, who underwent both studies. The intraclass correlation was 0.93, with high correlation (r = 082, r(s) = 0.83). CGCT detected smaller AA more often, and provided more information about the shape of atheromatous plaques.
CGCT is similar to TEE in detecting AA. CGCT may detect smaller atheromas and be better in defining atheroma morphology.
本研究旨在比较经食管超声心动图（TEE）和心脏门控计算机断层扫描（CGCT）在检测主动脉粥样硬化（AA）方面的效果。
有证据表明，AA可能是导致缺血性中风的栓子来源。TEE是检测中风患者心脏栓子来源的成熟工具，但在检测AA方面有明显局限性。
这是一项对2000年2月至11月间因缺血性中风入院患者的前瞻性研究。该队列中的患者均接受了TEE和CGCT检查以评估中风病因。CGCT研究由一位在胸部断层扫描方面有专业专长的放射科医生进行检索和解读，TEE研究由一位在解读和操作TEE方面有专业专长的超声心动图医生阅读。解读人员不知道对方获得的结果。通过测量毫米级的动脉粥样硬化厚度来评估AA。使用Bland-Altman和Pollock图对两种检查结果的关系进行图形分析。还估计了Pearson（r）、Spearman（r(s)）和组内相关检验的结果。
对32例同时接受了两种检查的患者，比较了CGCT和TEE测得的主动脉粥样硬化毫米级厚度。组内相关性为0.93，相关性较高（r = 0.82，r(s) = 0.83）。CGCT更常检测到较小的AA，并能提供更多关于动脉粥样斑块形状的信息。
CGCT在检测AA方面与TEE相似。CGCT可能能检测到更小的动脉粥样硬化斑块，并且在定义动脉粥样硬化形态方面表现更好。
