Nakamura K, Suzuki S, Satomi G, Adachi F, Hirosawa K, Takao A, Hashimoto A, Tokuyasu Y, Kusakabe K, Yamazaki T, Shigeta A
J Cardiogr. 1981 Mar;11(1):239-52.
The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intimal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia.
本研究的目的是比较二维超声心动图与其他方法在检测和定位瓣环主动脉扩张患者升主动脉瘤方面的诊断价值。对19例患者（12例马方综合征患者、4例主动脉炎综合征患者和3例术后瓣周动脉瘤患者）进行了二维超声心动图、RI血管造影、CT扫描和主动脉造影检查。12例马方综合征患者中有8例升主动脉夹层在手术或尸检时得到证实。获得了以下观察结果。1） 通过记录内膜撕裂和瓣片，在7例患者的二维超声心动图上清晰显示了升主动脉夹层，在这些病例中，升主动脉的短轴二维超声心动图在识别夹层的部位和范围方面更有用。2） 在术后瓣周动脉瘤患者中，RI血管造影被证明是一种更有用、更敏感的技术，可用于区分动脉瘤内漏血与动脉瘤内血栓。3） CT扫描被证明是一种不敏感的技术，无法检测升主动脉瘤夹层，也无法区分瓣周动脉瘤内的漏血与血栓。从这些观察结果来看，我们得出结论，二维超声心动图和RI血管造影被证明是检测升主动脉瘤夹层和评估瓣环主动脉扩张患者术后动脉瘤的敏感技术。
