经食道及经胸超声检测房颤患者左心耳血栓的对比研究

摘要

Objective To compare the effectiveness of application of TEE (Trans-Esophageal Echocardiography) and TTE (Trans-Thoracic Echocardiography) in detection of LAAT (Left Atrial Appendage Thrombus) in patients with AF (Atrial Fibrillation).Methods TEE and TTE examinations were simultaneously performed in 74 cases of patients with non-valvular AF so as to compare the detection of LAAT.Results Among 74 AF patients, TTE revealed 9 LAAT patients (12.16%) with 3 FP (False Positive) cases and 5 SEC (Spontaneous Echo Contrast) patients (6.76%) with 2 FP (False Positive) cases; while, TEE detected 24 cases of LAAT (32.43%) and 18 cases of SEC (24.32%). Statistically signiifcant differences existed between two methods. The ultrasonographic ifndings of LAAT showed abnormal echo clumps attached to the inner wall of LAA with low or slightly strong echos. The ultrasonography of LAA SEC revealed the swirling or cloudy signs inside the LAA, indicating the high risks of thrombus formation.Conclusion TEE demonstrated its advantages over TTE in detection of LAAT, which had signiifcant clinical effectiveness in treatment of AF.%目的：比较经食道超声（TEE）及经胸超声（TTE）在检测房颤患者左心耳血栓中的价值。方法对74例非瓣膜性房颤患者同时进行TEE和TTE检查，比较左心耳血栓的检出情况。结果74例房颤患者中，TTE检出左心耳血栓9例（12.16%），其中假阳性3例；检出左心耳自发显影（SEC）5例（6.76%），其中假阳性2例；TEE检出左心耳血栓24例（32.43%)、左心耳SEC18例（24.32%），两种方法比较具有统计学差异。超声表现：左心耳血栓表现为左心耳内壁异常回声团块附着，为低回声或稍强回声，左心耳SEC表现为左心耳内漩涡状或云雾状回声，提示血栓形成高危状态。结论 TEE对左心耳血栓的检出率明显高于TTE，对房颤治疗具有重要的临床价值。