经胸超声心动图及CTA诊断Stanford A型主动脉夹层的价值

Clinical Values of Transthoracic Echocardiography and Computed Tomography Angiography in Diagnosis of Stanford Type A Aortic Dissection

目的 评价经胸超声心动图(transthoracic echocardiography,TTE)、CT血管造影(computed tomography angiography,CTA)在诊断Stanford A型主动脉夹层(aortic dissection,AD)中的临床价值。方法 对22例Stanford A型AD患者的TTE、CTA检查结果及手术、病理进行回顾性分析。结果 TTE、CTA诊断Stanford A型AD与手术符合率分别为90.9%、95.5%,两者比较差异无统计学意义(P>0.05)。TTE的优势在于观察升主动脉近端病变、瓣膜反流及其严重程度及评估心功能、心包积液量。CTA的优势在于显示AD累及范围,尤其显示主动脉弓、胸腹主动脉、冠状动脉病变均优于TTE(P<0.05)。结论 TTE、CTA诊断AD各有优势,联合应用对AD诊疗方案的选择具有重要价值。

Objective To evaluate the clinical values of transthoracic echocardiography(TTE) and computed tomography angiography(CTA) in the diagnosis of Stanford type A aortic dissection(AD).Methods The TTE,CTA,pathologic reports and operative notes of 22 patients with type A AD were retrospectively analyzed.Results The diagnostic coincidence rate was 90.9% between TTE and operation,and 95.5% between CTA and operation(P >0.05).TTE was superior to CTA for observing proximal ascending aorta lesions and valvular regurgitation and evaluating cardiac function and pericardial effusion.However,CTA was superior to TTE for displaying the range of AD involvement,especially the lesions in aortic arch,thoracic and abdominal aorta and coronary artery(P<0.05).Conclusion The TTE and CTA have their respective advantages in the diagnosis of AD.Therefore,the combination of TTE and CTA is of great value in the selection of AD diagnosis and treatment schemes.