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[经食管超声心动图对胸主动脉夹层的诊断]

[Diagnosis of thoracic aorta dissection using transesophageal echocardiography].

作者信息

Hernández Herrera C, Morón-Malek A, Romero-Cárdenas A, Rijlaarsdam M, Vargas-Barrón J

机构信息

Departamento de Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, México, D.F.

出版信息

Arch Inst Cardiol Mex. 1994 Mar-Apr;64(2):183-8.

PMID:8074589
Abstract

During a 36 month period there were 20 patients in our hospital with aortic dissection suspected clinically. All of them were examined with transesophageal echocardiography (TEE); 17 were examined with transthoracic echocardiography (TTE); six with computed tomography (CT) and seven with aortography. Twelve patients required surgery: eight with proximal aortic dissection (Type-A), two with distal dissection (Type-B) and two with aortic aneurysm without dissection. With the goal of investigating the utility of TEE for the diagnosis of aortic dissection in our hospital, we compared this and other available methods to the surgery findings. The sensitivity to TEE was 100% and the specificity 92%, with test accuracy at 92%. The sensitivity of the other tests was low: 66% with TTE; 50% with TAC; 57%, with aortography. The specificity was 90% with TTE, and higher with CT and aortography (100%). The ultrasound tests reveal additional information about complications like aortic regurgitation. Transesophageal echocardiography is the best test to examine patients with aortic dissection in our hospital. Computed tomography, aortography and magnetic resonance imaging have indication only to answer specific doubts.

摘要

在36个月期间,我院有20例临床疑似主动脉夹层的患者。所有患者均接受了经食管超声心动图(TEE)检查;17例接受了经胸超声心动图(TTE)检查;6例接受了计算机断层扫描(CT)检查;7例接受了主动脉造影检查。12例患者需要手术治疗:8例为近端主动脉夹层(A型),2例为远端夹层(B型),2例为无夹层的主动脉瘤。为了研究TEE在我院诊断主动脉夹层中的实用性,我们将其与其他可用方法与手术结果进行了比较。TEE的敏感性为100%,特异性为92%,检测准确率为92%。其他检查的敏感性较低:TTE为66%;CT为50%;主动脉造影为57%。TTE 的特异性为90%,CT和主动脉造影的特异性更高(100%)。超声检查可提供有关主动脉瓣关闭不全等并发症的额外信息。经食管超声心动图是我院检查主动脉夹层患者的最佳检查方法。计算机断层扫描、主动脉造影和磁共振成像仅在解答特定疑问时有应用指征。

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