左心声学造影联合经食管超声心动图诊断心房颤动患者左心耳血栓的临床价值  

Clinical value of contrast enhanced transesophageal echocardiography in the diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation

作　　者：吕一飞 何文[1] 杜丽娟[1] 兰亭玉 张萌 张惠琴[1] 段凤霞[1] 张巍[1] LV Yifei;HE Wen;DU Lijuan;LAN Tingyu;ZHANG Meng;ZHANG Huiqin;DUAN Fengxia;ZHANG Wei(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100071

出　　处：《临床超声医学杂志》2025年第2期111-115,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨左心声学造影联合经食管超声心动图(CE-TEE)在心房颤动(以下简称房颤)患者左心耳血栓诊断中的临床价值。方法选取于我院就诊的房颤患者123例,应用常规经食管超声心动图(TEE)、CE-TEE观察左心耳内有无血流自显影及血栓形成,比较TEE与CE-TEE对房颤患者左心耳血栓的诊断情况。结果123例房颤患者中,最终确诊左心耳血栓14例,TEE仅检出6例,CE-TEE均检出,两种技术检出率比较差异有统计学意义(P<0.05);CE-TEE在左心耳血栓边界显示率及非活动性血栓检出率方面均优于TEE(100%vs.50.0%、57.1%vs.0),差异均有统计学意义(均P<0.05);二者在显示血栓回声、部位、形态方面比较差异均无统计学意义。结论CE-TEE能够清晰显示房颤患者左心耳血栓边界,提高非活动性血栓检出率,且在鉴别左心耳自显影与血栓形成方面也具有一定的临床应用价值。Objective To explore the clinical value of contrast enhanced transesophageal echocardiography(CETEE)in the diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation.Methods A total of 123 patients with atrial fibrillation in our hospital were selected,conventional transesophageal echocardiography(TEE)and CE-TEE were used to observe whether there was spontaneous echo contrast and thrombosis formation in the left atrial appendage.The attachment site,morphology,swing and echo characteristics of thrombosis were recorded when thrombosis was found.The diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation by TEE and CE-TEE was compared.Results Among the 123 patients with atrial fibrillation,14 cases were positive for thrombosis.Only 6 cases were diagnosed by TEE,while CE-TEE diagnosed accurately all of them,the difference in detection rate between the two techniques was statistically significant(P<0.05).CE-TEE was superior to TEE in terms of the display rate of thrombosis boundary and the detection rate of inactive thrombosis(100%vs.50.0%,57.1%vs.0),and the differences were statistically significant(both P<0.05).There were no statistically significant differences in thrombosis echo,location and morphology between the two techniques.Conclusion CETEE can clearly display the boundary of left atrial appendage thrombosis in patients with atrial fibrillation,improve the detection rate of inactive thrombosis,and also has a certain clinical application value in differentiating spontaneous echo contrast from thrombosis formation.

关 键 词：超声心动描记术 经食管 造影剂 左心耳 血栓 自显影 心房颤动 

分 类 号：R540.45[医药卫生—心血管疾病]