经胸超声心动图在A型急性主动脉夹层早期诊断中的价值

摘要

Objective To explore the value of transthoracic echocardiography (TTE) in the early diagnosis of type A acute aortic dissection.Methods The clinical data of 35 cases of Stanford A type AAD who were treated at our hospital in recent years were analyzed retrospectively.The examination of enhanced CT angiography (CTA) was taken as the golden standard,the accuracy and the characteristics of TTE detection were recorded.Results The accuracy of TTE was 91.4％,which was similar to that of CTA.TTE examination showed that aortic intima floating and/or aortic intramural hematoma accounted for 42.9％,pericardial effusion / pericardial tamponade accounted for 34.3％,ascending aortic diameter ＞ 42 mm accounted for 68.6％,and aortic valve regurgitation accounted for 54.3％.Conclusion The positive rate of Stanford A AAD diagnosed by TTE is similar to that by CTA;and clinicians can make an early diagnosis according to the positive results of direct and indirect signs.%目的 探究经胸超声心动图(TTE)在A型急性主动脉夹层(AAD)早期诊断中的价值.方法 回顾性分析本院近年收治的35例Stanford A型AAD患者行TTE检查的临床资料,以增强CT血管造影(CTA)检查为金标准,记录TTE检测准确率,并记录TTE检测特点.结果 TTE检查准确率为91.4％,与CTA检查相当.TTE检测显示主动脉内膜漂浮和/或主动脉壁内血肿占42.9％,心包积液/心包填塞占34.3％,升主动脉内径＞42 mm占68.6％,主动脉瓣反流占54.3％.结论 TTE与CTA诊断Stanford A型AAD的检出率相似,临床医师可根据其直接征象及间接征象阳性结果及早确诊.