CAJ | 학술논문

目的：探讨经胸超声心动图多切面扫查法对左心耳的显示及左心耳血栓检出的效果。方法入选32例心房颤动（房颤）患者，分别采用经胸二维超声心动图多切面扫查法及常规扫查法显示左心耳，并记录左心耳血栓的发生情况。常规扫查法采用调整的大动脉短轴切面进行观察，多切面扫查法在调整的大动脉短轴及其临近切面基础上同时进行调整的左心两腔切面及其邻近切面进行观察。以经食管超声心动图检查作为左心耳血栓检出的“金标准”，比较多切面扫查法和常规扫查法对左耳血栓检出的敏感性、特异性。结果经胸超声心动图对左心耳的显示率：常规扫查法为50.0%，多切面扫查法为81.2%，两种方法左心耳的显示率有统计学差异（P＜0.05）。常规扫查法检出左心耳血栓的敏感性为27.3%、特异性90.5%；多切面扫查法检出左心耳血栓的敏感性为63.6%，特异性为95.2%。对于左心耳血栓的检出，多切面扫查法与经食管超声心动图一致性更好，优于常规扫查法。结论多切面扫查法能提高经胸超声心动图对左心耳的显示效果及左心耳血栓的检出，具有一定的临床实用价值。
목적：탐토경흉초성심동도다절면소사법대좌심이적현시급좌심이혈전검출적효과。방법입선32례심방전동（방전）환자，분별채용경흉이유초성심동도다절면소사법급상규소사법현시좌심이，병기록좌심이혈전적발생정황。상규소사법채용조정적대동맥단축절면진행관찰，다절면소사법재조정적대동맥단축급기림근절면기출상동시진행조정적좌심량강절면급기린근절면진행관찰。이경식관초성심동도검사작위좌심이혈전검출적“금표준”，비교다절면소사법화상규소사법대좌이혈전검출적민감성、특이성。결과경흉초성심동도대좌심이적현시솔：상규소사법위50.0%，다절면소사법위81.2%，량충방법좌심이적현시솔유통계학차이（P＜0.05）。상규소사법검출좌심이혈전적민감성위27.3%、특이성90.5%；다절면소사법검출좌심이혈전적민감성위63.6%，특이성위95.2%。대우좌심이혈전적검출，다절면소사법여경식관초성심동도일치성경호，우우상규소사법。결론다절면소사법능제고경흉초성심동도대좌심이적현시효과급좌심이혈전적검출，구유일정적림상실용개치。
Objective To investigate the display and detection effects of multi-section scanning of transthoracic echocardiogram (TTE) to left atrial appendage (LAA) and left atrial appendage thrombosis (LAAT). Methods The patients (n=32) with atrial fibrillation (AF) were chosen and given respectively multi-section scanning or routine scanning of TTE for displaying LAA and recording the incidence of LAAT. The sensitivity and specificity of multi-section scanning and routine scanning to detection effects on LAAT were compared taken detection effect of transesophageal echocardiogram (TEE) as golden standard. Results The display rate of LAA was 50.0%by routine scanning and 81.2%by multi-section scanning (P<0.05). The sensitivity to LAAT was 27.3%and specificity was 90.5%by routine scanning, and sensitivity was 63.6%and specificity was 95.2%by multi-section scanning. For detection of LAAT, multi-section scanning and TEE had higher consistence and were better than routine scanning. Conclusion Multi-section scanning can improve the display effect and detection of TTE to LAAT with clinical practical value.