经食管超声心动图评估主动脉成像切面的临床探讨  

Alternative Views of Transesophageal Echocardiography in the Assessment of Aorta Structure

作　　者：孔令秋[1] 唐红[1] 康彧[1] 魏薪[1] 陈柳[1] 安琪[2] 宋海波[3] 

机构地区：[1]四川大学华西医院心内科,成都610041 [2]四川大学华西医院胸心血管外科,成都610041 [3]四川大学华西医院麻醉科,成都610041

出　　处：《四川大学学报（医学版）》2016年第1期97-101,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技支撑计划项目(No.2012FZ0065)资助

摘　　要：目的探讨经食管超声心动图(TEE)评估主动脉成像切面及其简化的操作流程。方法纳入337例在我院心脏外科行手术治疗的患者,分别沿"食管中段""食管上段""食管下段""胃底部"4个层面,逐一进行扫查。记录每一切面距离门齿的距离、成像角度等参数。结果 7例患者因TEE探头插入困难而退出,最终共有330例患者完整采集主动脉超声图像,其中5例患者因气体干扰,食管上段切面采集困难,术中放置自制气管内水囊辅助而完成图像采集。所有超声切面采集平均耗时(15.6±3.8)min。不同主动脉成像切面中,探头距门齿距离、成像角度及管体指向变化不一,且主动脉壁随成像切面的变化而变化。结论主动脉的超声评估是心脏外科术中的难点和重点,熟练掌握主动脉解剖及TEE成像规律,掌握灵活多变的检查方式,方能更好地开展术中TEE检查。Objective To investigate the imaging views and scanning procedure of the aorta using the transesophageal echocardiography（TEE）.Methods In accordance with the established TEE scanning process,337 patients had their aortas scanned on four different levels,including upper,middle,lower segment of esophagus and gastric base.All parameters such as the depth of probe,imaging angle were recorded.Results A total of 330 cases of patients completed the procedure,the other 7cases experienced the failure of TEE probe placement.Five patients received the new acoustic window for TEE imaging of large vessels anterior to the trachea by using a saline-filled endotracheal balloon,for the main structures anterior to the trachea were poorly visualized.The average timeconsuming of the scanning was（15.6±3.8）min.Depth of the probe,imaging angle and the aortic wall changed with the changing of imaging views.Conclusion It is important to be familiar with the aorta anatomy and TEE imaging features for the purpose of overcoming the difficult in the assessment of aorta on TEE imaging.

关 键 词：超声心动描记术 经食管 主动脉 

分 类 号：R654.2[医药卫生—外科学]