实时三维经胸超声和经食管超声心动图对左心耳血栓诊断的对比研究

Comparative research between real-time three-dimensional transthoracic echocardiography and transesophageal echocardiography for diagnosis of left atrial appendage thrombosis

目的探讨实时三维经胸超声(RT-3DTTE)、经食管超声心动图(TEE)对左心耳血栓(LAAT)的诊断价值。方法 34例LAAT患者,均于TEE检查前接受RT-3DTTE检查,采取双盲原则进行结果判断,以TEE诊断结果为标准,评价RT-3DTTE对于LAAT的诊断价值。结果 RT-3DTTE的诊断敏感性为71%,准确性高达74%,阳性、阴性预测值分别为75%和72%,观察者间判断保持一致良好(Kappa=0.475,P<0.05)。结论 RT-3DTTE作为一种LAAT诊断方式具有创伤小、无痛且重复性好的优点,同TEE进行初步比较,在对比结果中显示出了良好的高敏性和运行预测性。

ObjectiveTo investigate diagnostic value by real-time three-dimensional transthoracic echocardiography （RT-3DTTE） and transesophageal echocardiography （TEE） for left atrial appendage thrombosis （LAAT）.MethodsA total of 34 LAAT patients received RT-3DTTE before TEE, and their outcomes were estimated under double-blind principle. TEE result was taken as evaluation standard for diagnostic value by RT-3DTTE for LAAT.ResultsRT-3DTTE showed diagnosis sensitivity as 71% and accuracy as 74%, and its positive and negative predicted values were 75% and 72%. Inter-observer variation showed good accordance （Kappa=0.475,P〈0.05）.ConclusionRT-3DTTE contains advantages of small damage, pain free and good repeatability in diagnosis of LAAT. It shows high sensitivity and good predictability in brief comparison with TEE.