Erbel R, Börner N, Steller D, Brunier J, Thelen M, Pfeiffer C, Mohr-Kahaly S, Iversen S, Oelert H, Meyer J
Br Heart J. 1987 Jul;58(1):45-51. doi: 10.1136/hrt.58.1.45.
The diagnostic value of a combination of transoesophageal and transthoracic echocardiography was evaluated in 21 patients with dissection of the aorta. The results were compared with those of computed tomography, aortography, and with findings at operation or necropsy or both. Transthoracic echocardiography identified three of the four patients with type I dissection, two of the five patients with type II dissection, and one of the 12 patients with type III dissection. When transoesophageal echocardiography was used as well the degree of aortic dissection was identified correctly in all 21 patients. In one patient with type I and in eight patients with type III dissection spontaneous echocardiographic contrast with a mural thrombus within the false lumen could be detected. Computed tomography was unable to demonstrate an intimal flap in one of two patients studied with type I dissection, in two of three patients with type II dissection, and in one of nine patients with type III dissection. Aortography was negative in one of two patients studied with type I dissection, two of four patients with type II dissection, and in one of eight patients with type II dissection. The whole thoracic aorta can be imaged by a combination of transthoracic and transoesophageal echocardiography. The addition of transoesophageal echocardiography to transthoracic echocardiography improves the recognition of aortic dissection. Furthermore, this examination can be performed at the bedside and the findings can be used as a basis for treatment.
对21例主动脉夹层患者评估了经食管和经胸超声心动图联合检查的诊断价值。将结果与计算机断层扫描、主动脉造影以及手术或尸检结果（或两者）进行比较。经胸超声心动图识别出4例I型夹层患者中的3例、5例II型夹层患者中的2例以及12例III型夹层患者中的1例。当同时使用经食管超声心动图时，21例患者的主动脉夹层程度均被正确识别。在1例I型和8例III型夹层患者中，可检测到假腔内有附壁血栓的自发超声造影。计算机断层扫描在2例I型夹层研究患者中的1例、3例II型夹层患者中的2例以及9例III型夹层患者中的1例中未能显示内膜瓣。主动脉造影在2例I型夹层研究患者中的1例、4例II型夹层患者中的2例以及8例II型夹层患者中的1例中呈阴性。经胸和经食管超声心动图联合检查可对整个胸主动脉成像。在经胸超声心动图基础上加用经食管超声心动图可提高对主动脉夹层的识别。此外，该检查可在床边进行，其结果可作为治疗的依据。
