超声诊断二叶主动脉瓣合并感染性心内膜炎  

Echocardiographic diagnosis of bicuspid aortic valve combined with infective endocarditis

作　　者：马青艳[1] 陈欧迪[1] 费洪文[1] 简旭华[2] 林琼雯 谢秋 许瑞雪 MA Qingyan;CHEN Oudi;FEI Hongwen;JIAN Xuhua;LIN Qiongwen;XIE Qiu;XU Ruixue(Department of Noninvasive Cardiology,Guangdong Cardiovascular Institute,Guangdong Academy of Medicine Sciences,Guangdong Provincial People's Hospital,Guangzhou 510080,China;Department of Cardiac Surgery,Guangdong Cardiovascular Institute,Guangdong Academy of Medicine Sciences,Guangdong Provincial People's Hospital,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所,广东省医学科学院广东省人民医院心血管辅助诊断科,广东广州510080 [2]广东省心血管病研究所,广东省医学科学院,广东省人民医院心脏外科,广东广州510080

出　　处：《中国医学影像技术》2020年第4期503-507,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省医学科研基金(A2019182)。

摘　　要：目的观察经胸超声心动图(TTE)和三维经食管超声心动图(3D-TEE)诊断二叶主动脉瓣(BAV)合并感染性心内膜炎(IE)的价值。方法回顾性分析53例BAV合并IE患者的超声图像,超声表现包括赘生物、瓣膜穿孔、脓肿和瘘道。以外科手术所见作为金标准,评估TTE和3D-TEE的超声特征及其诊断价值。结果3D-TEE检出赘生物、瓣膜穿孔、脓肿和瘘道的敏感度(100%vs.90.20%,96.87%vs.90.62%,92.86%vs.67.86%,94.12%vs.70.59%)和阳性预测值均高于TTE(100%vs.95.83%,100%vs.93.55%,96.30%vs.86.36%,100%vs.85.71%,P均<0.05)。结论超声心动图对于BAV合并IE的总体检出率高。3D-TEE的可视性和空间分辨率比TTE更好,诊断BAV合并IE敏感度和阳性预测值更高。Objective To explore the value of transthoracic echocardiography(TTE)and three-dimensional transesophageal echocardiography(3D-TEE)in diagnosis of bicuspid aortic valve(BAV)combined with infective endocarditis(IE).Methods Ultrasonic data of 53 BAV combined with IE patients were retrospective reviewed.The ultrasonic findings of BAV combined with IE included vegetation,leaflet perforation,abscess and fistula.The ultrasonic features and diagnostic value of TTE and 3D-TEE were evaluated taken surgical findings as the gold standards.Results The sensitivity and positive predictive value of 3D-TEE were both higher than those of TTE in detecting vegetation,leaflet perforation,abscess and fistula(100%vs.90.20%,96.87%vs.90.62%,92.86%vs.67.86%,94.12%vs.70.59%and 100%vs.95.83%,100%vs.93.55%,96.30%vs.86.36%,100%vs.85.71%,all P<0.05).Conclusion The echocardiographic detection rate of BAV combined with IE is very high.3D-TEE has better visibility and higher spatial resolution than TTE,therefore having higher sensitivity and positive predictive value in diagnosis of BAV combined with IE.

关 键 词：二叶主动脉瓣 超声心动描记术 经食管 超声心动描记术 心内膜炎 

分 类 号：R542.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]