超声心动图和多层螺旋CT对急诊主动脉夹层的诊断效能对比  

Comparison of Diagnostic Efficacy of Echocardiography and Multi-slice Spiral CT in Emergency Aortic Dissection

作　　者：杨超[1] 彭莹子[2] 李玉峰[1] 张梦 熊智巍 YANG Chao;PENG Yingzi;LI Yufeng;ZHANG Meng;XIONG Zhiwei(Department of Ultrasound,Panzhihua Central Hospital,Panzhihua,Sichuan 617000,China;Panzhihua Disease Control and Prevention Center,Panzhihua,Sichuan 617000,China;Department of Vascular Diseases,Panzhihua Central Hospital,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市中心医院超声科,四川攀枝花617000 [2]攀枝花市疾病预防控制中心,四川攀枝花617000 [3]攀枝花市中心医院血管疾病科,四川攀枝花617000

出　　处：《临床误诊误治》2023年第8期122-126,共5页Clinical Misdiagnosis & Mistherapy

基　　金：攀枝花市科技计划项目(2020ZD-S-25)。

摘　　要：目的 分析超声心动图和多层螺旋CT对急诊主动脉夹层的诊断价值。方法 选取2020年1月—2022年10月经主动脉造影确诊的主动脉夹层180例。比较超声心动图与多层螺旋CT对主动脉夹层的诊断价值。结果 本研究中180例主动脉夹层,其中Stanford A型123例(68.3%),Stanford B型57例(31.7%)。超声心动图诊断主动脉夹层的总体符合率为95.6%(172/180),其中对Stanford A型主动脉夹层诊断的符合率为100%(123/123),与多层螺旋CT比较差异无统计学意义(P>0.05)。超声心动图对Stanford B型主动脉夹层诊断的符合率为86.0%(49/57),低于多层螺旋CT的100%(57/57)(P<0.05)。超声心动图对主动脉瓣异常诊断的符合率为100%(129/129),高于多层螺旋CT的82.9%(107/129)(P<0.05)。超声心动图对主动脉弓异常诊断的符合率为96.2%(153/159),低于多层螺旋CT的100%(159/159)。结论 在诊断和评估主动脉夹层时,超声心动图与多层螺旋CT各有优缺点和诊断价值,在患者血流动力学稳定情况下应联合应用,从而对主动脉夹层和心脏功能做出全面和准确评估。Objective To analyze the diagnostic value of echocardiography and multi-slice spiral CT in patients with emergency aortic dissection(AD).Methods A total of 180 patients with AD diagnosed by aortic angiography from January 2020 to October 2022 were selected.The diagnostic value of echocardiography and multi-slice spiral CT in AD was compared.Results In this study,there were 180 patients with AD,including 123 cases(68.3%)of Stanford type A and 57 cases(31.7%)of Stanford type B.The overall coincidence rate of echocardiography in the diagnosis of AD was 95.6%(172/180),and the coincidence rate of Stanford type A AD was 100%(123/123),which had no significant difference compared with multi-slice spiral CT(P>0.05).The coincidence rate of Stanford type B AD by echocardiography was 86.0%(49/57),which was lower than that of multi-slice spiral CT(100%,57/57)(P<0.05).The coincidence rate of echocardiography for aortic valve abnormality was 100%(129/129),which was higher than that of multi-slice spiral CT(82.9%,107/129)(P<0.05).The coincidence rate of echocardiography for the diagnosis of abnormal aortic arch was 96.2%(153/159),which was lower than that of multi-slice spiral CT(100%,159/159).Conclusion In the diagnosis and evaluation of AD,echocardiography and multi-slice spiral CT have advantages and disadvantages and diagnostic value,and should be combined when the patient's hemodynamics are stable,so as to make a comprehensive and accurate evaluation of the patient's AD and cardiac function.

关 键 词：动脉瘤 夹层 Stanford A型 Stanford B型 主动脉造影术 升主动脉 超声心动图 体层摄影术 螺旋计算机 诊断 

分 类 号：R543.16[医药卫生—心血管疾病]