Minard G, Schurr M J, Croce M A, Gavant M L, Kudsk K A, Taylor M J, Pritchard F E, Fabian T C
Department of Surgery, University of Tennessee, Memphis 38163, USA.
J Trauma. 1996 Feb;40(2):225-30. doi: 10.1097/00005373-199602000-00009.
Recently, transesophageal echocardiography (TEE) has been proposed as the standard for the diagnosis of traumatic disruption of the aorta (TDA), replacing aortography. The purpose of this study was to evaluate the accuracy and practicality of TEE in the diagnosis of TDA.
Prospective clinical trial.
Patients with blunt trauma admitted with a suspected diagnosis of TDA were evaluated with TEE and aortography.
Thirty-four patients were evaluated with TEE and aortography. TEE was unsuccessful in five patients (15%). Of the remaining 29 patients, TEE results were true-positive in four and true-negative in 20. TEE results were false-positive in two patients, and three injuries were missed (two were proximal to the left subclavian artery, and one was a localized aortic disruption). Sensitivity and specificity of TEE were 57% and 91%, respectively, compared with aortography, for which sensitivity was 89% and specificity was 100%.
Although the use of TEE in the diagnosis of TDA has several advantages, it is not more accurate than aortography. TEE should not replace aortography as the standard for the diagnosis of TDA.
最近，经食管超声心动图（TEE）已被提议作为主动脉创伤性破裂（TDA）诊断的标准，取代主动脉造影。本研究的目的是评估TEE在TDA诊断中的准确性和实用性。
前瞻性临床试验。
对疑似诊断为TDA的钝性创伤患者进行TEE和主动脉造影评估。
34例患者接受了TEE和主动脉造影评估。5例患者（15%）TEE检查失败。在其余29例患者中，TEE结果为4例假阳性，20例假阴性。2例患者TEE结果为假阳性，3处损伤漏诊（2处位于左锁骨下动脉近端，1处为局限性主动脉破裂）。与主动脉造影相比，TEE的敏感性和特异性分别为57%和91%，主动脉造影的敏感性为89%，特异性为100%。
虽然TEE在TDA诊断中的应用有几个优点，但它并不比主动脉造影更准确。TEE不应取代主动脉造影作为TDA诊断的标准。
