分节段多模式主动脉超声探查对急性主动脉综合征的诊断价值  

Segmental Interrogation of Aorta with Ultrasonic Multi-Imaging Modalities for Diagnosis of Acute Aortic Syndrome

作　　者：周劭洁 钟玲[2] 曾元洪 

机构地区：[1]莆田市涵江医院超声科,莆田351111 [2]福建医科大学附属协和医院心内科,福州350001 [3]莆田市涵江医院影像科,莆田351111

出　　处：《福建医科大学学报》2014年第6期378-381,共4页Journal of Fujian Medical University

摘　　要：目的探讨超声成像术(USI)对急性主动脉综合征(AAS)的诊断价值。方法在87例急性胸痛、临床高度疑似AAS患者中,应用分节段多模式主动脉超声探查术检测主动脉病变,并与CT血管造影(CTA)检测结果进行盲法对比分析。结果 87例患者最终确诊为AAS为76例。USI对AAS的检出率低于CTA,差异主要在于对主动脉壁内血肿(IMH)的敏感性低;对AAS及其伴随异常如撕裂口、分支受累的敏感性不如CTA,但对AAS并发主动脉瓣关闭不全高度敏感;对纵膈血肿不敏感,但对心包、胸腔积血的敏感性与CTA相当。对非AAS所致的急性胸痛病因鉴别诊断优于CTA。结论分节段多模式主动脉超声探查术有助于提高AAS的检出率;在急性胸痛病因的快速甄别中具有较重要的临床价值。Objective To explore the diagnostic values of ultrasound imaging （USI） in patients with suspected acute aortic syndrome （AAS） . Methods In 87 patients with acute chest pain who were suspected with AAS ,segmental aortic imaging by USI with multi‐modalities was performed to interrogate aortic abnormalities in multiple acoustic widows ,the USI‐derived findings were compared with those de‐tected by CTA by blink analysis . ResuIts 76 cases out of 87 suspected patients were finally diagnosed as AAS . Compared to CTA ,USI tended to be lower sensitivity to detect AAS particularly for identifica‐tion of aortic intramural hematoma （IM H）;USI was inferior to detect AAS‐associated abnormalities such as intimal tearing entrance ,branch compromising ,but superior to identify aortic regurgitation . Despite insensitivity to mediastinal hematoma ,USI was identical in detection of pericardial and thoracic effusion . Additionally ,USI was more favorable to classify the causes of acute chest pain . ConcIusions Segmen‐tal aortic imaging by USI with multi‐modalities is helpful to identify AAS ,to differentiate the causes of acute chest pain regardless of lower sensitiveness for AAS .

关 键 词：超声检查 体层摄影术 螺旋计算机 血管造影术 主动脉 主动脉疾病 综合征 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]