摘要
目的探讨经胸超声心动图（TTE）对主动脉窦瘤及其合并症诊断的应用价值。方法回顾分析2007年10月至2014年3月北京军区总医院超声科应用经胸超声心动图诊断的15例主动脉窦瘤患者,男性11例,女性4例,年龄范围23~75岁,平均年龄（40.93±17.06）岁。应用TTE诊断主动脉窦瘤及主动脉窦瘤破裂合并室间隔缺损,并计算诊断的敏感性、特异性、阳性预测值、阴性预测值以及准确度。分析各病理分型及其合并症图像特征,与术中所见进行对比。结果 15例患者中,窦瘤破裂8例（53.3%）,平均年龄（32.25±7.85）岁;未破裂7例（46.7%）,平均年龄（50.85±19.81）岁。窦瘤破裂患者的平均年龄较未破裂患者高,差异有统计学意义（P〈0.05）。以外科术中所见为金标准,TTE诊断主动脉窦瘤破裂的敏感性、特异性、阳性预测值、阴性预测值、准确度分别为100%（8/8）、85.7%（6/7）、88.8%（8/9）、100%（6/6）和93.3%（14/15）,诊断主动脉窦瘤破裂合并室间隔缺损分别为50%（3/6）、100%（9/9）、100%（3/3）、75%（9/12）和80%（12/15）。根据超声图像进行病理分型,除1例无法分型外,Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型所占比例分别为26.67%（4/15）、46.67%（7/15）、0%和20%（3/15）。14例患者术中测量窦瘤基底宽度与TTE测量结果差异无统计学意义（P=0.77）。结论 TTE可准确诊断主动脉窦瘤及其合并症,对窦瘤进行病理分型,对主动脉窦瘤诊疗工作具有重要价值。
Objective To discuss the application value of transthoracic echocardiography （TFE） to diagnosis of aneurysm of sinus of Valsalva （SVA） and its complications. Methods The patients [n=15, male 11, female 4 and aged from 23 to 75 （40.93 ± 17.06）] were given retrospective analysis from Oct. 2007 to Mar. 2014. The diagnoses of SVA and ruptured SVA （RSVA） complicating ventricular septai defect （VSD） were carried out by using TTE, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. The pathological types and image features of all complications were analyzed and compared with findings in surgery. Results Among 15 cases, there were 8 cases （53.3%） with RSVA （mean aged 32.25 ±7.85） and 7 cases （46.7%） without RSVA （mean aged 50.85 ± 19.81, P〈0.05）. Taken findings in surgery as gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TTE for diagnosing RSVA were, respectively, 100% （8/8）, 85.7% （6/7）, 88.8% （8/9）, 100% （6/6） and 93.3% （14/15）, and those of TTE for diagnosing RSVA complicating VSD were, respectively, 50% （3/6）, 100% （9/9）, 100% （3/3）, 75% （9/12） and 80% （12/15）. The pathological types according to ultrasonography, except of 1 case, including type I , type lI, type III and type 1V accounted, respectively, for 26.67% （4/15）, 46.67% （7/15）, 0% and 20% （3/15）. The difference hetween SVA base width detected in surgery and TTE outcome had no statistical significance （P=0.77） in 14 patients. Conclusion TTE can accurately diagnose SVA and its complications, and is valued to SVA pathological typing, diagnosing and treating in clinic.
出处
《中国循证心血管医学杂志》
2015年第1期60-63,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
主动脉窦瘤
破裂
经胸超声心动图
Aneurysm of sinus of Valsalva
Rupture
Transthoraeic echocardiography
