经食管超声心动图在心源性脑栓塞性脑梗死中的应用

Transesophageal Echocardiography in Cardiogenic Embolic Cerebral Infarction.

作者信息

Chu Wen, Wang Hua

机构信息

Wen Chu, Ultrasonic Department, Luoyang Central Hospital Affiliated to Zhengzhou University, Henan, 471000, China.

Hua Wang, Ultrasonic Department, Luoyang Central Hospital Affiliated to Zhengzhou University, Henan, 471000, China.

出版信息

Pak J Med Sci. 2018 Jan-Feb;34(1):58-61. doi: 10.12669/pjms.341.13291.

DOI:10.12669/pjms.341.13291

PMID:29643879

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5857030/

Abstract

OBJECTIVE

To evaluate the diagnostic values of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in cardiogenic embolic cerebral infarction.

METHODS

Fifty patients with occult cerebral infarction who were admitted to the hospital between June 2015 and June 2016 were selected as research subjects. The patients were diagnosed by transesophageal echocardiography and transthoracic echocardiography. Diagnostic data were compared to analyze the values of the two diagnostic methods.

RESULTS

Sixteen out of fifty patients were diagnosed as cardiogenic embolic cerebral infarction by TEE (32%), including two cases of aortic plaques, six cases of atrial septal defect, two cases of atrial septal aneurysm, two cases of patent foramen ovale, one case of left atrial spontaneous echo contrast, one case of mitral prolapse and two case of mitral stenosis. Four cases were diagnosed as cardiogenic embolic cerebral infarction by TTE (8.0%), including one case of patent foramen ovale, one case of left atrial spontaneous echo contrast, one case of mitral prolapse and one case of mitral stenosis. The difference was statistically significant (P<0.05). The main difference of TEE and TTE was detection of aorta atheromatous plaques and atrial septal lesions. Aortic atheromatous plaques of two cases and atrial septal lesions of eight cases were missed in the diagnosis by TTE.

CONCLUSION

Detection and diagnosis of cardiac embolic cerebral infarction with TEE is highly accurate and advantageous. Therefore, TEE is worth promotion and application.

摘要

目的

评估经食管超声心动图（TEE）和经胸超声心动图（TTE）在心源栓塞性脑梗死中的诊断价值。

方法

选取2015年6月至2016年6月期间收治的50例隐匿性脑梗死患者作为研究对象。对患者进行经食管超声心动图和经胸超声心动图检查。比较诊断数据，分析两种诊断方法的价值。

结果

50例患者中，16例经TEE诊断为心源栓塞性脑梗死（32%），包括主动脉斑块2例、房间隔缺损6例、房间隔瘤2例、卵圆孔未闭2例、左心房自发显影1例、二尖瓣脱垂1例、二尖瓣狭窄2例。4例经TTE诊断为心源栓塞性脑梗死（8.0%），包括卵圆孔未闭1例、左心房自发显影1例、二尖瓣脱垂1例、二尖瓣狭窄1例。差异有统计学意义（P<0.05）。TEE与TTE的主要差异在于对主动脉粥样斑块和房间隔病变的检测。TTE诊断漏诊主动脉粥样斑块2例、房间隔病变8例。