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Usefulness of the echocardiographic paravertebral approach for the diagnosis of descending thoracic aortic dissection

机译:超声心动图椎旁入路对诊断降主动脉夹层的有用性

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BackgroundTransthoracic echocardiography (TTE) is not recommended as the first-line diagnostic modality for Stanford type B aortic dissection (type-B AD).PurposesThe aims of this study were to evaluate the usefulness and factors influencing for the diagnosis of type-B AD using the transthoracic echocardiographic paravertebral approach (PVA).MethodsWe compared the image acquisition rate of descending thoracic aorta (DTA) and the diagnostic rate of type-B AD using TTE versus PVA. Both tests were compared with type-B AD, which was diagnosed by enhanced computed tomography (CT), as the reference standard. We also analyzed the factors influencing adequate image acquisition and the diagnosis of type-B AD using the PVA. The length between the dorsal thoracic surface and the DTA (TDAL) and thickness of lung on the TDAL line (LTh) were measured on the CT images.ResultsNo significant difference was found between the image acquisition rate of the DTA between the PVA and the TTE (70.1 vs. 64.2%, p?=?0.56), while the diagnostic rate of type-B AD using the PVA was significantly greater than when using the TTE (56.7 vs. 26.9%, p?
机译:背景不建议将胸腔超声心动图(TTE)作为斯坦福B型主动脉夹层(B型AD)的一线诊断方法。本​​研究的目的是评估使用B超诊断的B型AD诊断的有用性和影响因素。方法我们比较TTE和PVA对胸降主动脉(DTA)的图像采集率和B型AD的诊断率。两项测试均与通过增强型计算机断层扫描(CT)诊断的B型AD进行比较,作为参考标准。我们还分析了影响适当图像采集和使用PVA诊断B型AD的因素。在CT图像上测量背胸表面与DTA之间的长度(TDAL)和TDAL线上的肺厚度(LTh)。结果PVA与TTE之间DTA的图像采集率没有明显差异。 (70.1 vs. 64.2%,p≥0.56),而使用PVA的B型AD的诊断率显着高于使用TTE时的诊断率(56.7 vs. 26.9%,p≤0.001)。此外,当使用PVA获得足够的DTA图像时,有80.9%的患者被诊断为B型AD。多因素分析表明,较低的LTh(p <= 0.001)和胸腔积液(p = 0.03)显着影响了使用PVA对B型AD的诊断。结论PVA可能是一种有用的方法当获得足够的DTA图像时,诊断B型AD。

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