主动脉假性动脉瘤的超声心动图表现及漏误诊分析  

Echocardiographic manifestations of aortic pseudoaneurysm and analysis of missed diagnosis and misdiagnosis

作　　者：薛超[1] 赵映[1] 张烨[1] 谷孝艳[1] 孙琳[1] 何怡华[1] XUE Chao;ZHAO Ying;ZHANG Ye;GU Xiaoyan;SUN Lin;HE Yihua(Department of Ultrusound,Beijing Anzhen Hospital,Capital Medical University,Beijng Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所超声心动科二部

出　　处：《心肺血管病杂志》2019年第5期518-521,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划(2018YFC1002300);北京市科学技术委员会资助项目(Z181100001918008);北京市医院管理局临床医学发展专项经费资助(XMLX201604);胎儿心脏病母胎医学北京市重点实验室(BZ0308);心血管疾病精准医学北京实验室(PXM2017_014226_000037)

摘　　要：目的:总结主动脉假性动脉瘤的临床及超声心动图表现,超声漏诊误诊的原因。方法:回顾性分析经手术或者造影明确诊断的主动脉假性动脉瘤的患者117例,总结主动脉假性动脉瘤的临床及超声心动图表现,超声漏诊误诊分析。结果:主动脉假性动脉瘤患者117例,行超声心动图检查共89例,其中9例提示主动脉显示不清。假性动脉瘤24(24/80)例,正确诊断率30%;主动脉增宽或者扩张22(22/80)例,主动脉夹层7(7/80)例,误诊率36.3%;超声结果正常27(27/80)例,漏诊率为33.8%。主动脉破口10~25 mm,瘤体横径45~125 mm,平均为(74.58±17.97)mm,瘤体横径/破口比例>1。超声心动图表现:主动脉壁的回声中断,周围假性动脉瘤形成,其内可见缓慢血流及血栓形成。结论:主动脉假性动脉是超声检查容易漏诊误诊的疾病,但识别超声表现,可以提高超声对假性动脉瘤的诊断率,减少漏诊和误诊。Objective:To summarize the echocardiographic features of aortic pseudoaneurysms and analyze the missed diagnosis and misdiagnosis.Methods:Retrospectively analyzed 117 cases,summarized the echocardiographic features,clinical manifestations and missed diagnosis and misdiagnosis.Results:Among 117 patients,echocardiography in 89 cases,of which 9 was unclear.24 cases(24/80)were pseudoaneurysm,positive rate 30%;22 cases(22/80)were aortic widening or dilation,7 cases(7/80)were aortic dissection,misdiagnosis rate 36.3%.Ultrasound result of normal 27 cases(27/80),the missed diagnosis rate was 33.8%.Aortic rupture(10~25)mm,transverse diameter of the tumor(45~125)mm,average(74.58±17.97)mm,ratio>1.Echocardiographic manifestations:the echo of aortic wall was interrupted,and the surrounding pseudoaneurysm was formed.Conclusions:Aortic pseudoaneurysm is easy to be missed,but if we can understand the ultrasonic manifestations,we can raise the the diagnosis of pseudoaneurysm by ultrasound and reduce the missed diagnosis and misdiagnosis.

关 键 词：主动脉假性动脉瘤 超声心动图描记 

分 类 号：R54[医药卫生—心血管疾病]