超声心动图诊断主动脉夹层效能分析

Effectiveness of Echocardiography in Diagnosis of Aortic Dissection

目的探讨超声心动图诊断主动脉夹层效能分析。方法回顾性分析2019年1月至2020年1月于我院急诊收治并联合手术后确诊为主动脉夹层患者56例为研究对象,分别采用经胸超声心动图(transthoracic echocardiography,TTE)与多层螺旋CT(Multi-slice spiral,CT MSCT)检查,并观察单一和联合诊断方法对主动脉夹层分型、血栓、心包积液和破裂口的检出率,并分析TTE、MSCT诊断主动脉夹层的灵敏度、特异度。结果 TTE与MSCT在主动脉夹层Ⅰ型和Ⅱ型的检出率无差异,而MSCT对于Ⅲ型主动脉夹层的检出率优于超声心动图(P<0.05)。TTE和MSCT联合诊断对血栓和破裂口的检出率较单一采用TTE和MSCT方式明显升高,单一采用MSCT对血栓和破裂口的检出率优于单一采用TTE的方式(P<0.05),单一方式和联合诊断方法对心包积液的检出率无差异;TTE诊断ADA的阳性预测值为68.0%,阴性预测值为25.3%,准确度为50.0%,灵敏度为56.7%,特异度为33.3%,均低于MSCT。结论超声心动图是主动脉夹层早期诊断的有效检查手段,并与多层螺旋CT扫描的一致性较好。

Objective To investigate the diagnostic efficiency of echocardiography in aortic dissection.Methods from January 2019 to January 2020, 56 patients with aortic dissection who were admitted to the emergency department of our hospital from January 2019 to January 2020 were retrospectively analyzed. Transthoracic echocardiography(TTE) and multi slice spiral CT(multislice spiral CT) were used respectively The detection rates of single and combined diagnostic methods for aortic dissection classification, thrombosis, pericardial effusion and laceration were observed, and the sensitivity and specificity of TTE and MSCT in the diagnosis of aortic dissection were analyzed.Results There was no difference between TTE and MSCT in the detection rate of typeⅠand typeⅡaortic dissection, while the detection rate of MSCT for typeⅢaortic dissection was better than that of echocardiography(P<0.05). The detection rate of thrombus and rupture in TTE combined with MSCT was significantly higher than that of TTE and MSCT alone(P<0.05),and the detection rate of single mode and combined diagnosis method for pericardial effusion had no difference;the positive predictive value of TTE in the diagnosis of ADA was 68.0%, the negative predictive value was 25.3%, and the accuracy was 25.3% The sensitivity, specificity and sensitivity of MSCT were 50.0%, 56.7% and 33.3%, respectively.Conclusion rdiography is an effective method for early diagnosis of aortic dissection, and has good consistency with multi-slice spiral CT scan.