Enia F, Ledda G, Lo Mauro R, Matassa C, Raspanti G, Stabile A
Divisione di Cardiologia dell'Ospedale V. Cervello, Palermo, Italy.
Chest. 1989 Jan;95(1):124-9. doi: 10.1378/chest.95.1.124.
We report our prospective experience with sensitivity, specificity, predictive values and efficiency of echocardiography in diagnosing AD involving the ascending aorta (type A). We studied two groups of patients with both echocardiography and aortography. Group 1 was made up by 46 consecutive patients with clinical suspicion of AD. Type A AD was confirmed in 23 cases. Group 2 was comprised of 509 adult patients who had been studied during the same period with both aortography and echocardiography (including 46 patients from group 1); prevalence of type A AD in this group was 4.9 percent. We conclude that the diagnostic usefulness of echocardiography in patients with suspected type A AD is limited by its moderate sensitivity and predictive positive value. Aortography remains the major step in diagnosis. Within these limitations, echocardiography is useful in confirmation of clinical suspicion if all three main echocardiographic signs are present (predictive positive value: 100 percent).
我们报告了超声心动图在诊断累及升主动脉的主动脉夹层（A型）时的敏感性、特异性、预测值及有效性方面的前瞻性经验。我们研究了两组同时接受超声心动图和主动脉造影检查的患者。第一组由46例临床怀疑主动脉夹层的连续患者组成。其中23例确诊为A型主动脉夹层。第二组由509例同期接受主动脉造影和超声心动图检查的成年患者组成（包括第一组的46例患者）；该组中A型主动脉夹层的患病率为4.9%。我们得出结论，超声心动图对疑似A型主动脉夹层患者的诊断价值因其中等的敏感性和阳性预测值而受到限制。主动脉造影仍是诊断的主要步骤。在这些限制条件下，如果出现所有三个主要超声心动图征象，超声心动图有助于证实临床怀疑（阳性预测值：100%）。
