经食管实时三维超声心动图与经食管二维超声心动图诊断房颤患者左心耳血栓的比较研究  

Comparison of Real-time Three-dimensional Transesophageal Echocardiography and Two-dimensional Transesophageal Echocardiography in Detection of Thrombus in Patients with Atrial Fibrillation in the Left Atrial Appendage

作　　者：谢洪宇[1] 曲秀芬[1] 李阳[2] 沈景霞[3] 尹德春[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,哈尔滨市150001 [2]哈尔滨医科大学附属第四医院心内科 [3]哈尔滨医科大学附属第一医院心脏彩超室,哈尔滨市150001

出　　处：《中国超声医学杂志》2012年第10期925-928,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维经食管超声心动图(real time three-dimensional transesophageal echocardiography,RT-3DTEE)结合二维经食管超声心动图(two-dimensional transesophageal echocardiography,2D-TEE)在诊断左心耳血栓方面的价值。方法选择239例房颤(atrial fibrillation,AF)患者,接受2D-TEE及RT-3DTEE检测。分别记录下二维模式以及二维结合三维模式下左心耳血栓的例数,并将结果与临床诊断进行比较分析,以评价RT-3DTEE结合2D-TEE在诊断LAA自发显影(spontaneous echo contrast,SEC)及血栓方面的价值。结果诊断左心耳自发显影,二维模式发现156例,三维模式发现41例;诊断左心耳血栓,二维模式发现62例,二维结合三维模式发现43例。结论 RT-3DTEE结合2DTEE较2D-TEE能更准确地检测出房颤患者左心耳血栓,但对左心耳自发显影的诊断,2D-TEE较RT 3DTEE更有优势。Objective To explore the value of the diagnosis of left atrial appendage thrombus by using real-time three-dimensional transesophagealechocardio graphy（RT-3DTEE）combined with two-dimensional transesophageal ech- ocardiography （2D-TEE）. Methods 239 cases of patients with atrial fibrillation, were selected for 2D-TEE and RT- 3DTEE detection, the number of left atrial appendage thrombi in the two-dimensional mode and two-dimensional add three-dimensional were recorded respectively, and the results were compared with clinical diagnosis to evaluate the val- ue of the diagnosis of spontaneous echo contrast（SEC） and thrombosis of left atrial appendage by using RT 3DTEE combined with 2D-TEE. Results SEC： 156 patients in 2D-TEE,41 patients in RT-3DTEE; Thrombus：62 patients in 2D-TEE,43 patients in 2D-TEE add RT 3DTEE. Conclusions 2D-TEE ＋ RT-3DTEE can improve the accuracy of diagnosis of thrombi in LAA than 2D-TEE alone;RT-3DTEE was inferior to 2D-TEE for diagnosis of SEC.

关 键 词：经食管实时三维超声心动图 左心耳 自发显影 血栓 房颤 

分 类 号：R540.45[医药卫生—心血管疾病] R541.75[医药卫生—内科学]