主动脉假性动脉瘤的超声心动图表现及漏误诊分析

Echocardiographic manifestations of aortic pseudoaneurysm and analysis of missed diagnosis and misdiagnosis

目的:总结主动脉假性动脉瘤的临床及超声心动图表现,超声漏诊误诊的原因。方法:回顾性分析经手术或者造影明确诊断的主动脉假性动脉瘤的患者117例,总结主动脉假性动脉瘤的临床及超声心动图表现,超声漏诊误诊分析。结果:主动脉假性动脉瘤患者117例,行超声心动图检查共89例,其中9例提示主动脉显示不清。假性动脉瘤24(24/80)例,正确诊断率30%;主动脉增宽或者扩张22(22/80)例,主动脉夹层7(7/80)例,误诊率36.3%;超声结果正常27(27/80)例,漏诊率为33.8%。主动脉破口10~25 mm,瘤体横径45~125 mm,平均为(74.58±17.97)mm,瘤体横径/破口比例>1。超声心动图表现:主动脉壁的回声中断,周围假性动脉瘤形成,其内可见缓慢血流及血栓形成。结论:主动脉假性动脉是超声检查容易漏诊误诊的疾病,但识别超声表现,可以提高超声对假性动脉瘤的诊断率,减少漏诊和误诊。

Objective:To summarize the echocardiographic features of aortic pseudoaneurysms and analyze the missed diagnosis and misdiagnosis.Methods:Retrospectively analyzed 117 cases,summarized the echocardiographic features,clinical manifestations and missed diagnosis and misdiagnosis.Results:Among 117 patients,echocardiography in 89 cases,of which 9 was unclear.24 cases(24/80)were pseudoaneurysm,positive rate 30%;22 cases(22/80)were aortic widening or dilation,7 cases(7/80)were aortic dissection,misdiagnosis rate 36.3%.Ultrasound result of normal 27 cases(27/80),the missed diagnosis rate was 33.8%.Aortic rupture(10~25)mm,transverse diameter of the tumor(45~125)mm,average(74.58±17.97)mm,ratio>1.Echocardiographic manifestations:the echo of aortic wall was interrupted,and the surrounding pseudoaneurysm was formed.Conclusions:Aortic pseudoaneurysm is easy to be missed,but if we can understand the ultrasonic manifestations,we can raise the the diagnosis of pseudoaneurysm by ultrasound and reduce the missed diagnosis and misdiagnosis.