双平面食管超声与经胸超声对左心耳血栓的诊断价值  

Comparative Study on Detection of Left Atrial Appendage Thrombi by Transesophageal and Transthoracic Echocardiography

作　　者：陈良龙[1] 游又庭[1] 林丽珍[1] 李金国[1] 

机构地区：[1]福建医学院附属协和医院心血管病中心

出　　处：《中国超声医学杂志》1994年第9期26-28,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：应用经胸及双平面食管超声心动图（ＴＴＥ和ＴＥＥ）检测５５例手术证实的风湿性二尖瓣病变者左心耳血栓形成情况，ＴＥＥ对左心耳血栓的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为１００％、９７．４％、９４．１％、１００％及９８．２％，而ＴＴＥ的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为３１．３％、８９．７％、５５．６％、７６．０％、及７２．７％。左心耳血栓多附着于心耳顶部及外侧壁。结果表明：ＴＥＥ对左心耳的检测价值明显高于ＴＴＥ；双平面ＴＥＥ不能进一步提高ＴＥＥ对左心耳血栓的检测能力；提高ＴＴＥ对左心耳的检测能力有赖于对左心耳的完整显示及对血栓附着部位的认识。This study was designed to detect a left atrial appendage(LAA)thrombus(LAA-Th),its appearance and attachment in patients with rheumatic heart disease by tranessophageal echOcardiography(TEE)and transthoracic ecchocardiography(TTE).Fifty-five patients with or without LAA-Th were comfirmed operatively.The sensitivity,specificity,positive predicted value,negative predicted value and accuracy for detect-ing LAA-Ths by TEE and TTE were l00%vs 3l.3%,97.4%vs 89.7%、94.1%vs55.6%、100%vs 76.O%and 98.2%vs 72.7%、respectively.LAA-Ths were usually attached to the top or/and the lateral wall of LAAand never to the medial wall of LAA。we conclude TEE is superior to TTE in the detection of LAA-Ths,Bipla-nar TEE can not cnhance t he diagnostic capacity of LAA-Ths.To enhance the capacity of TTE for detecting LAA+Ths relies on the full imaging of LAA.

关 键 词：经胸超声心动图 双平面食管超声心动图 左心耳血栓. 

分 类 号：R445.1[医药卫生—影像医学与核医学]