Job F P, Franke S, Lethen H, Flachskampf F A, Hanrath P
Medical Clinic I, Rheinisch Westfälische Technische Hochschule Aachen, Germany.
Am J Cardiol. 1995 May 15;75(15):1033-7. doi: 10.1016/s0002-9149(99)80719-x.
In 41 patients with clinical evidence of active infective endocarditis, transesophageal echocardiography was performed in a stepwise manner, starting with evaluation of the monoplane views, followed by the longitudinal plane, and finally by the intermediate planes. Number, location, length, area, density, extent, and mobility of vegetations and abscesses were assessed in the monoplane, biplane, and best intermediate planes to identify and quantify the incremental value of the longitudinal and intermediate planes. Eighty-three vegetations and 6 abscesses were found. In 4 patients (10%) monoplane evaluation yielded false-negative results. There were no false-negative results using the biplane evaluation. However, when compared with multiplane evaluation, additional vegetations were missed in 23% of patients after monoplane and in 9% of patients after biplane evaluation. Three abscesses were missed using the monoplane and 1 was missed using the biplane technique. The area was underestimated in 60% of all vegetations (mean underestimation, 37% +/- 23% [SD] of maximal area) and length in 49% of cases (mean underestimation, 38% +/- 23% [SD] of maximal length) of all vegetations when biplane was compared with multiplane evaluation. Also, with monoplane and biplane evaluation, mobility and density were misinterpreted in 6% and 5% and 17% and 9% of all vegetations, respectively. Thus, multiplane transesophageal echocardiography is more accurate than the monoplane and biplane techniques in assessing patients with active infective endocarditis.
在41例有活动性感染性心内膜炎临床证据的患者中，经食管超声心动图检查采用逐步检查的方式进行，首先评估单平面视图，接着是纵切面，最后是中间平面。在单平面、双平面和最佳中间平面评估赘生物和脓肿的数量、位置、长度、面积、密度、范围及活动度，以确定并量化纵切面和中间平面的增加值。共发现83个赘生物和6个脓肿。4例患者（10%）单平面评估出现假阴性结果。双平面评估未出现假阴性结果。然而，与多平面评估相比，单平面评估后23%的患者以及双平面评估后9%的患者有额外的赘生物被漏诊。单平面检查漏诊了3个脓肿，双平面检查漏诊了1个脓肿。与多平面评估相比，双平面评估时，所有赘生物中60%的面积被低估（平均低估最大面积的37%±23%[标准差]），49%的病例赘生物长度被低估（平均低估最大长度的38%±23%[标准差]）。此外，在单平面和双平面评估中，所有赘生物中分别有6%和5%的活动度以及17%和9%的密度被误判。因此，在评估活动性感染性心内膜炎患者时，多平面经食管超声心动图比单平面和双平面技术更准确。
