Evangelista Arturo, Flachskampf Frank A, Erbel Raimund, Antonini-Canterin Francesco, Vlachopoulos Charalambos, Rocchi Guido, Sicari Rosa, Nihoyannopoulos Petros, Zamorano Jose, Pepi Mauro, Breithardt Ole-A, Plonska-Gosciniak Edyta
Servei de Cardiologia, Hospital Vall d'Hebron, P degrees Vall d'Hebron 119, 08035 Barcelona, Spain.
Eur J Echocardiogr. 2010 Sep;11(8):645-58. doi: 10.1093/ejechocard/jeq056.
Echocardiography plays an important role in the diagnosis and follow-up of aortic diseases. Evaluation of the aorta is a routine part of the standard echocardiographic examination. Transthoracic echocardiography (TTE) permits adequate assessment of several aortic segments, particularly the aortic root and proximal ascending aorta. Transoesophageal echocardiography (TOE) overcomes the limitations of TTE in thoracic aorta assessment. TTE and TOE should be used in a complementary manner. Echocardiography is useful for assessing aortic size, biophysical properties, and atherosclerotic involvement of the thoracic aorta. Although TOE is the technique of choice in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. However, a negative TTE does not rule out aortic dissection and other imaging techniques must be considered. TOE should define entry tear location, mechanisms and severity of aortic regurgitation, and true lumen compression. In addition, echocardiography is essential in selecting and monitoring surgical and endovascular treatment and in detecting possible complications. Although other imaging techniques such as computed tomography and magnetic resonance have a greater field of view and may yield complementary information, echocardiography is portable, rapid, accurate, and cost-effective in the diagnosis and follow-up of most aortic diseases.
超声心动图在主动脉疾病的诊断和随访中发挥着重要作用。主动脉评估是标准超声心动图检查的常规部分。经胸超声心动图（TTE）能够充分评估主动脉的多个节段，尤其是主动脉根部和升主动脉近端。经食管超声心动图（TOE）克服了TTE在胸主动脉评估中的局限性。TTE和TOE应相互补充使用。超声心动图有助于评估胸主动脉的大小、生物物理特性和动脉粥样硬化累及情况。虽然TOE是诊断主动脉夹层的首选技术，但在紧急情况下TTE可作为初始检查方法。TTE可轻松显示升主动脉近端的内膜瓣、心包积液/心包填塞及左心室功能。然而，TTE检查结果阴性并不能排除主动脉夹层，必须考虑采用其他影像学检查技术。TOE应明确破口位置、主动脉瓣反流的机制和严重程度以及真腔受压情况。此外，超声心动图对于选择和监测手术及血管内治疗以及检测可能的并发症至关重要。尽管计算机断层扫描和磁共振成像等其他影像学检查技术视野更广泛，可能提供补充信息，但在大多数主动脉疾病的诊断和随访中，超声心动图具有便携、快速、准确且经济高效的特点。
