Niedermeyer J, Daniel W G
Zentrum Innere Medizin und Dermatologie, Medizinische Hochschule Hannover.
Z Kardiol. 1993;82 Suppl 2:13-20.
The technology of echocardiographic imaging is now widely available and has become increasingly important in the diagnosis of severe pulmonary embolism. In this setting transthoracic two-dimensional echocardiography (TTE) permits a rapid and non-invasive bed-side assessment of right ventricular size and systolic function. Doppler techniques facilitate precise measurements of pulmonary arterial pressures. These parameters can be easily followed after initiating therapy and allow to recognize patients refractory to the chosen therapeutic regimen. With transesophageal echocardiography (TEE), as well as with TTE, direct visualization of thromboembolic material within the central pulmonary arteries or the right heart chambers is possible. TEE, however, is more sensitive than TTE in detecting thrombotic or embolic material. It is also superior in the diagnosis of a patent foramen ovale which may indicate impending paradoxical embolism. The role of intravascular ultrasound imaging in clinical practice is not clear yet. It may be helpful in the localization and differential diagnosis of thromboembolic material in the pulmonary vascular bed.
超声心动图成像技术现已广泛应用，在严重肺栓塞的诊断中变得越来越重要。在这种情况下，经胸二维超声心动图（TTE）可对右心室大小和收缩功能进行快速、无创的床边评估。多普勒技术有助于精确测量肺动脉压力。在开始治疗后，可以轻松跟踪这些参数，并识别对所选治疗方案无效的患者。经食管超声心动图（TEE）与TTE一样，可以直接观察中央肺动脉或右心室内的血栓栓塞物质。然而，TEE在检测血栓形成或栓塞物质方面比TTE更敏感。在诊断可能提示即将发生矛盾栓塞的卵圆孔未闭方面也更具优势。血管内超声成像在临床实践中的作用尚不清楚。它可能有助于肺血管床中血栓栓塞物质的定位和鉴别诊断。
