Pruszczyk P, Torbicki A, Kuch-Wocial A, Chlebus M, Miśkiewicz Z C, Jedrusik P
Department of Hypertension and Angiology, Warsaw Medical Academy, Poland.
Eur Heart J. 1995 Apr;16(4):534-8. doi: 10.1093/oxfordjournals.eurheartj.a060947.
Transesophageal echocardiographic evaluation of right and left pulmonary arteries, up to the origin of their lobar branches, was prospectively performed with a single plane probe in 32 consecutive patients (18 M, 14 F, aged 55.5 +/- 14.6, from 32 to 80 years) with clinical or echocardiographic suspicion of pulmonary embolism, who met transthoracic echocardiographic criteria of right ventricular overload. Transoesophageal echocardiography showed unequivocal (20 patients) or suspected (three patients) intraluminar thrombi in 88.5% of 26 patients with haemodynamically significant acute or chronic pulmonary embolism, confirmed with reference methods. The sensitivity of the unequivocal transoesophageal echocardiographic diagnosis was 80% for acute and 73% for chronic haemodynamically significant pulmonary embolism. No false-positive results were found (specificity 100%). Additionally, in three cases, transoesophageal echocardiography disclosed the cause of the right ventricular overload revealing a previously undiagnosed atrial septal defect or Ebstein anomaly. Direct visualization of proximal pulmonary arterial thrombi by transoesophageal echocardiography emerges as a useful new method of prompt and definite diagnosis of haemodynamically important pulmonary embolism.
对32例连续患者（18例男性，14例女性，年龄55.5±14.6岁，32至80岁）进行前瞻性经食管超声心动图检查，使用单平面探头评估左右肺动脉直至其叶分支的起源，这些患者临床或超声心动图怀疑有肺栓塞，且符合经胸超声心动图右心室负荷过重标准。经食管超声心动图显示，在26例有血流动力学显著意义的急性或慢性肺栓塞患者中，88.5%（20例明确诊断，3例疑似诊断）的患者腔内有血栓，经参考方法证实。明确的经食管超声心动图诊断对急性血流动力学显著意义的肺栓塞敏感性为80%，对慢性者为73%。未发现假阳性结果（特异性100%）。此外，在3例患者中，经食管超声心动图揭示了右心室负荷过重的原因，发现了先前未诊断出的房间隔缺损或埃布斯坦畸形。经食管超声心动图直接观察近端肺动脉血栓，成为快速明确诊断血流动力学重要肺栓塞的一种有用新方法。
