超声心动图经胸骨上窝切面探查诊断肺栓塞  

Ultrasound Echocardiography through Suprasternal Fossa View in Diagnosis of Pulmonary Embolism

作　　者：张燕辉[1] 黄嘉成[1] 米骏麟 陈献明[1] 

机构地区：[1]深圳市宝安区松岗人民医院功能科,广东深圳518105

出　　处：《现代临床医学》2016年第4期259-261,共3页Journal of Modern Clinical Medicine

摘　　要：目的:探讨胸骨上窝左、右肺动脉长轴切面在肺栓塞诊断中的应用价值,以提高超声对肺栓塞诊断的准确率。方法:对我院2014年1月至2015年1月经CT肺动脉造影(CT pulmonary angiography,CTPA)加三维重建诊断为肺栓塞患者18例行常规超声心动图检查,并增加胸骨上窝切面探查左、右肺动脉,显示左肺动脉主干近端、右肺动脉主干及右上肺动脉、右下肺动脉近端,观察管腔内回声及病变所在的位置,以CDFI显示左、右肺动脉内血流充盈情况。结果与CTPA加三维重建对比,比较胸骨上窝切面与胸骨旁切面在肺栓塞诊断中的效果。结果:18例肺栓塞患者中,胸骨上窝切面探查发现肺动脉内低回声或中等回声团块15例,2例显示受限。其中13例位于左和(或)右肺动脉,2例位于右肺动脉分支近端。与CTPA加三维重建结果对比后,12例符合,3例为超声伪像,符合率、假阳性率分别为66.67%、16.67%。胸骨旁切面探查发现左和(或)右肺动脉内低回声或中等回声团块13例,2例显示受限。与CTPA加三维重建结果对比后,7例符合,6例为超声伪像,符合率、假阳性率分别为38.89%、33.33%。结论:胸骨上窝切面可清晰显示左肺动脉主干近端、右肺动脉主干及其分支近端内血栓,检出肺栓塞直接征象的阳性率、准确率高于胸骨旁切面,是中央型肺栓塞超声诊断方法的重要补充,应作为肺栓塞患者的常规探查切面。Objective： To investigate the diagnostic value of the long axis view of the left and right pulmonary artery in the diagnosis of pulmonary embolism, and to improve the accuracy of the diagnosis of pulmonary embolism. Methods：Echocardiography was performed in 18 patients with pulmonary embolism,which were diagnosed by CTPA plus 3D reconstruction from January 2014 to January 2015 in our hospital. Through suprasternal long axis view,proximal left main pulmonary artery,right main pulmonary artery,right superior pulmonary artery and right inferior pulmonary artery were explored; the intraluminal echoes and location of the embolism were observed. Blood flow of left and right pulmonary arteries was detected by color Doppler flow imaging（ CDFI）. The results of echocardiography were compared with those of CTPA and 3D reconstruction,and the effect of suprasternal fossa view was compared with that of parasternal view in the diagnosis of pulmonary embolism. Results： Among 18 cases of pulmonary embolism,there were 15 ones of low or moderate echo mass in the pulmonary artery detected by suprasternal fossa echocardiography,but 2 cases showed the limitation; the echo masses of 13 cases were located in the left and（ or） right pulmonary arteries,and those of 2 case were located in proximal branches of the right pulmonary artery. The results of ultrasound echocardiography in 12 cases were in accordance with those of CTPA and 3D reconstruction; 3 cases showed the ultrasonic artifacts. The coincidence rate and false positive rate were 66. 67% and 16. 67%,respectively. Through parasternal view,the low or moderate echo mass in the left or（ and） right pulmonary artery was found in 13 cases,and 2 cases showed the limitation. The results of ultrasound echocardiography in 7 cases were in accordance with those of CTPA and 3D reconstruction,but 6 cases showed the ultrasonic artifacts. The coincidence rate and false positive rate were 38. 89% and 33. 33%, respectively.Conclusion： Through suprasternal fossa view,the thrombus

关 键 词：肺栓塞 超声心动图 胸骨上窝 直接征象 

分 类 号：R563.5[医药卫生—呼吸系统]