经食管超声心动图与增强CT在心房颤动患者拟行射频消融术前左心耳血栓检测中的研究

发布时间：2018-03-26 13:53

本文选题：心房颤动　切入点：左心耳血栓　出处：《中国超声医学杂志》2017年08期

【摘要】：目的探讨经食管超声心动图与增强CT在心房颤动患者拟行射频消融术前左心耳血栓检测中的应用价值。方法对194例拟行射频消融治疗的心房颤动患者,术前均行经胸、食管超声和增强CT检查,分别记录下检出血栓的例数,将血栓情况与临床诊断进行比较分析,评价经食管超声和增强CT在诊断LAA血栓方面的价值。结果 194例心房颤动患者经胸超声检出左心耳血栓3例;经食管超声检出左心耳血栓51例;增强CT检出左心耳血栓17例;经临床诊断证实存在左心耳血栓33例。增强CT对左心耳血栓检测的灵敏度45%、特异度98%、阳性预测值88%;经食管超声检测左心耳血栓的灵敏度97%、特异度88%、阳性预测值62%。结论增强CT检测左心耳内血栓的特异度较高,经食管超声结合增强CT检查是心房颤动患者拟行射频消融术前左心耳血栓的有效检查手段。
[Abstract]:Objective to investigate the value of transesophageal echocardiography and enhanced CT in detecting left atrial appendage thrombosis before radiofrequency ablation in patients with atrial fibrillation. Esophageal ultrasonography and enhanced CT were used to record the number of cases of thrombus detected, and to compare the thrombus with clinical diagnosis. Results left atrial auricular thrombosis was detected by transthoracic ultrasound in 3 cases, left atrial auricular thrombosis in 51 cases by transesophageal ultrasound, left atrial auricular thrombosis in 17 cases by contrast enhanced CT. 33 cases of left atrial auricular thrombosis were confirmed by clinical diagnosis. The sensitivity, specificity and positive predictive value of enhanced CT in detecting left atrial auricular thrombosis were 45%, 98%, 88%, and 97%, 88% and 62%, respectively. Conclusion the specificity of enhanced CT in detecting left atrial thrombus is high. Transesophageal ultrasonography combined with enhanced CT is an effective method for detecting left atrial appendage thrombosis before radiofrequency ablation in patients with atrial fibrillation.
【作者单位】：沈阳军区总医院心内科;
【基金】：辽宁省科学技术计划项目(No.2015020443)
【分类号】：R540.45;R541.75;R816.2

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