A 3-dimensional transoesophageal echocardiography perspective of mitral valve abscess

An 85-year-old female with history of dementia presented with concern for severe sepsis and was found to have methicillin sensitive staphylococcus aureus bacteremia complicated by atrial fibrillation.For further workup,a transoesophageal echocardiography(TOE)was obtained.The study revealed a large echogenic density with multiple echolucent areas within the finding.There was evidence of blood flow in these echolucent areas based on color flow imaging.This mass was intermittently protruding into the left ventricle causing a function mitral stenosis.The collective findings on echocardiography,in context of bacteremia,were highly suggestive of mitral valve abscess(Figure 1).

3D-TEE与TTE检查对感染性心内膜炎赘生物的诊断效能分析

目的:探讨经食管三维超声心动图(3D-TEE)与经胸超声心动图(TTE)检查对感染性心内膜炎赘生物的诊断效能。方法:选取2017年8月-2019年10月于本院接受心脏手术治疗的感染性心内膜炎患者84例,均行TTE、3D-TEE检查。以手术病理诊断为金标准,分析TTE、3D-TEE对感染性心内膜炎赘生物的诊断效能,比较两种检查方法对瓣周脓肿和瓣叶穿孔的检测准确率。结果:84例患者中有64例存在感染性心内膜炎赘生物。3D-TEE诊断感染性心内膜炎赘生物阳性63例,阴性21例。TEE诊断感染性心内膜炎赘生物阳性64例,阴性20例。3D-TEE诊断感染性心内膜炎赘生物的特异度、敏感度、诊断准确率、阴性与阳性预测值均高于对照组(P<0.05)。3D-TEE对瓣周脓肿和瓣叶穿孔的检测准确率均高于TTE(P<0.05)。结论:与TTE相比,3D-TEE诊断感染性心内膜炎赘生物具有高敏感度、高特异度,能提高感染性心内膜炎赘生物检出率,并准确判断患者是否存在瓣周脓肿和瓣叶穿孔等并发症,指导临床治疗。