经食管与经胸超声心动图诊断风湿性心脏病左房血栓的对比研究

Comparison study of transesophageal and transthoracic echocardiography in diagnosis of left atrial thrombi in patients with rheumatic heart disease

目的对比研究经食管超声心动图(TEE)与经胸超声心动图(TTE)对风湿性心脏病患者左房及左心耳血栓的诊断价值。方法对162例风湿性心脏病患者先后行TTE和TEE检查,对左房血栓、左心耳血栓的检出情况进行总结分析。结果 TTE检出血栓者15例,检出率9.26%,血栓位于左房腔内9例,单纯位于左心房耳部5例,左房与左房耳部并存1例,有自发云雾状回声者2例。TEE检出血栓者42例,检出率25.9%,血栓位于左房腔内2l例,耳部17例,左房与左心耳部并存4例,有自发云雾状回声者11例。结论 TEE对左心房、耳部血栓的检出率显著高于TTE,且可降低TTE误诊率。

Objective To explore the value of transesophageal and transthoracic echocardiography （ TEE and TFE） in diagnosis of left atrial thrombi （LAT） and left atrial appendage （LAAT） thrombi in patients with rheumatic heart disease. Methods One hundred and sixty -two patients with rheumatic heart disease were examined by TTE and TEE, then the condition of their LAT and LAAT was analyzed. Results There were 15 patients with thrombi were examined by TTE, the detection rate was 9.26% , 9 cases of LAT,5 cases of LAAT, 1 case of LAT combined with LAAT, and 2 cases with spontaneous cloudiness echo. While there were 42 patients with thrombi were examined by TEE, the detection rate was 25.9% , 21 cases of LAT, 17 cases of LAAT,4 cases of LAT combined with LAAT, and 11 cases with spontaneous cloudiness echo. Conclusion The detection rate of TEE in diagnosis of LAT and LAAT is higher than that of TTE, and it can decrease the misdiagnosis rate of TTE.