Kronzon I, Tunick P A, Freedberg R S, Trehan N, Rosenzweig B P, Schwinger M E
Department of Medicine, New York University Medical Center, New York.
J Am Coll Cardiol. 1991 Feb;17(2):537-42. doi: 10.1016/s0735-1097(10)80128-7.
The purpose of this study was to compare transthoracic and transesophageal echocardiography in the diagnosis of various types of atrial septal defects. Forty-one adult patients with the clinical diagnosis of atrial septal defect were studied by transthoracic and transesophageal echocardiography (30 women, 11 men; 18 to 81 years of age). Transthoracic echocardiography demonstrated the atrial septal defect in 33 patients (secundum type in 28, primum type in 3 and sinus venosus type in 2). Transesophageal echocardiography demonstrated the defect in all 41 patients. Thus, in 8 (20%) of 41 patients the atrial septal defect was demonstrated by transesophageal and not by transthoracic echocardiography. Six of the eight had a sinus venosus type atrial septal defect; the other two patients had a secundum atrial septal defect (one of these two had a technically poor transthoracic echocardiogram and the other had a small atrial septal defect). Transthoracic echocardiography, therefore, failed to demonstrate the sinus venosus defect in six (75%) of eight patients. An anomalous venous connection associated with the sinus venosus defect was visualized by transesophageal echocardiography in seven of the eight patients but was not seen on transthoracic echocardiography in any patient. Sinus venosus type atrial septal defects are frequently not visualized in adults by conventional transthoracic echocardiography. Transesophageal echocardiography is recommended when an atrial septal defect is clinically suspected but cannot be visualized by transthoracic echocardiography.
本研究的目的是比较经胸超声心动图和经食管超声心动图在诊断各种类型房间隔缺损中的应用。对41例临床诊断为房间隔缺损的成年患者进行了经胸和经食管超声心动图检查（30例女性，11例男性；年龄18至81岁）。经胸超声心动图在33例患者中显示出房间隔缺损（继发孔型28例，原发孔型3例，静脉窦型2例）。经食管超声心动图在所有41例患者中均显示出缺损。因此，在41例患者中有8例（20%）经食管超声心动图显示有房间隔缺损，而经胸超声心动图未显示。这8例中的6例为静脉窦型房间隔缺损；另外2例患者为继发孔型房间隔缺损（其中1例经胸超声心动图技术欠佳，另1例房间隔缺损较小）。因此，经胸超声心动图在8例患者中的6例（75%）未能显示静脉窦缺损。8例患者中有7例经食管超声心动图显示出与静脉窦缺损相关的异常静脉连接，而经胸超声心动图在任何患者中均未发现。成人常规经胸超声心动图常无法显示静脉窦型房间隔缺损。当临床上怀疑有房间隔缺损但经胸超声心动图无法显示时，建议采用经食管超声心动图检查。
