经多平面经食管超声心动图描绘冠状动脉的延长段。

Delineation of extended lengths of coronary arteries by multiplane transesophageal echocardiography.

作者信息

Tardif J C, Vannan M A, Taylor K, Schwartz S L, Pandian N G

机构信息

Cardiovascular Imaging and Hemodynamic Laboratory, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111.

出版信息

J Am Coll Cardiol. 1994 Oct;24(4):909-19. doi: 10.1016/0735-1097(94)90849-4.

DOI:10.1016/0735-1097(94)90849-4

PMID:7930224

Abstract

OBJECTIVES

The purpose of this study was to evaluate the utility of multiplane transesophageal echocardiography in assessing the coronary artery tree.

BACKGROUND

Evaluation of coronary disease with single-plane and biplane transesophageal echocardiography is limited to the very proximal vessels. The numerous views provided by multiplane imaging may enhance visualization of coronary arteries and detection of their abnormalities.

METHODS

Intraoperative multiplane transesophageal echocardiography was performed in 45 consecutive adults who had recently undergone angiography. Recordings were reviewed in blinded manner.

RESULTS

We describe the coronary segments visualized with the different imaging planes and define new views. The left main coronary artery with its bifurcation was visualized in all 45 patients. Sensitivity and specificity for detection of coronary narrowings were 100% when results were compared with angiographic data. Visualization of proximal, mid and distal segments of the left anterior descending coronary artery was possible in 69%, 31% and 16% of patients, respectively. Among patients in whom the proximal segment was visualized, sensitivity and specificity for detection of significant narrowings were 80% and 100%. Proximal, mid and distal portions of the left circumflex coronary artery were visualized in 80%, 51% and 20% of patients. Among patients in whom the proximal portion was well seen, sensitivity and specificity were 89% and 100%. The proximal, mid and distal portions of the right coronary artery were visualized in 84%, 16% and 11% of patients. Among patients in whom the proximal segment was visualized, sensitivity and specificity were 82% and 100%. Color Doppler examination was less useful because it detected only 52% of all patients with proximal stenosis.

CONCLUSIONS

Multiplane transesophageal echocardiography allows enhanced visualization of extended lengths of coronary arteries and the reliable identification of coronary artery abnormalities.

摘要

目的

本研究旨在评估多平面经食管超声心动图在评估冠状动脉树方面的效用。

背景

单平面和双平面经食管超声心动图对冠心病的评估仅限于非常近端的血管。多平面成像提供的众多视图可能会增强冠状动脉的可视化及其异常的检测。

方法

对45例近期接受血管造影的连续成年患者进行术中多平面经食管超声心动图检查。记录以盲法进行回顾。

结果

我们描述了用不同成像平面可视化的冠状动脉节段并定义了新的视图。所有45例患者均可见左主干冠状动脉及其分叉。与血管造影数据比较时，检测冠状动脉狭窄的敏感性和特异性均为100%。分别有69%、31%和16%的患者可以看到左前降支冠状动脉的近端、中段和远端节段。在可见近端节段的患者中，检测明显狭窄的敏感性和特异性分别为80%和100%。分别有80%、51%和20%的患者可以看到左旋支冠状动脉的近端、中段和远端部分。在近端部分清晰可见的患者中，敏感性和特异性分别为89%和100%。分别有84%、16%和11%的患者可以看到右冠状动脉的近端、中段和远端部分。在可见近端节段的患者中，敏感性和特异性分别为82%和100%。彩色多普勒检查用处较小，因为它仅检测出所有近端狭窄患者中的52%。