Grewal K S, Malkowski M J, Kramer C M, Dianzumba S, Reichek N
Allegheny University of the Health Sciences, Allegheny General Hospital, Pittsburgh, PA, USA.
J Am Soc Echocardiogr. 1998 Oct;11(10):966-71. doi: 10.1016/s0894-7317(98)70139-7.
Although the role of multiplane transesophageal echocardiography in the diagnosis of flail mitral valve leaflet is well described, the accuracy of this modality in localizing the involved posterior leaflet scallop (medial, middle, or lateral) has never been validated. For 54 patients undergoing intraoperative transesophageal echocardiography for severe mitral regurgitation due to flail mitral valve leaflet, we assessed the accuracy of a systematic approach to localization of the flail mitral valve leaflet. Surgical confirmation was performed for all patients. At blinded review, a sensitivity of 78%, specificity of 92%, and overall diagnostic accuracy of 88% were achieved for correct localization of the flail posterior leaflet scallop. The middle scallop was most commonly affected in this series. The medial scallop was affected least often, and diagnosis of lesions in that area was least accurate. This diagnostic approach appears to be accurate and feasible and may assist in planning specific surgical therapy for this disorder.
尽管多平面经食管超声心动图在诊断连枷样二尖瓣叶方面的作用已得到充分描述，但该方法在定位受累的后叶扇贝（内侧、中间或外侧）方面的准确性从未得到验证。对于54例因连枷样二尖瓣叶导致严重二尖瓣反流而接受术中经食管超声心动图检查的患者，我们评估了一种系统的连枷样二尖瓣叶定位方法的准确性。所有患者均进行了手术确认。在盲法评估中，连枷后叶扇贝正确定位的敏感性为78%，特异性为92%，总体诊断准确性为88%。在本系列中，中间扇贝最常受累。内侧扇贝受累最少，该区域病变的诊断准确性最低。这种诊断方法似乎准确可行，可能有助于为这种疾病制定具体的手术治疗方案。
