经食道超声心动图及CT在左心耳封堵术前检查中的应用价值

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摘要目的：评估经食道超声心动图及CT在左心耳封堵术前的应用价值。方法：回顾性分析2013年5月—2016年4月武汉亚洲心脏病医院118例房颤拟行左心耳封堵术患者的术前经食道超声心动图（TEE）及CT结果。结果：入选患者118例，女75例，男43例，年龄（55.6±5.8）岁。118例TEE发现左心耳血栓10例，108例CT发现左心耳充盈缺损者5例。根据CT结果将左心耳形态分型：鸡翅型（56例，51.9%），菜花型（22例，20.3%），风向标型（21例，19.4%），仙人掌型（9例，8.4%）。左心耳口形态分型：椭圆形（95例，88.0%），类圆形（8例，7.4%），水滴形（5例，4.6%)。结论：术前TEE可在左心耳封堵术前有效的筛选出左心耳血栓患者，术前左心耳CT检查可提供更多左心耳解剖信息，二种技术结合使用可为手术的成功提供更准确的支持。

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	余正春
	马小静
	夏娟
	李菁

关键词 ：心耳, 超声心动描记术, 经食管, 体层摄影术, 螺旋计算机

Abstract：Objective: To evaluate the value of trans-esophageal echocardiography(TEE) and CT in the pre-operation of left atrial appendage occlusion. Methods: One hundred and eighteen pre-operative TEE and CT results of left atrial fibrillation fitting left atrial appendage occlusion were selected to analysis retrospectively from May 2013 to April 2016. Results: One hundred and eighteen patients were enrolled, including 43 males and 75 females, mean age (55.6±5.8) years. TEE was shown 10 patients with thrombus in the left atrial appendage, CT was shown 5 patients filling defect in left atrial appendage. According to the shape of left atrial appendage, 4 types were individed: chicken wing type(56 cases, 51.9%), cauliflower type(22 cases, 20.3%), vane type(21 cases, 19.4%), cactus type(9 cases, 8.4%). Left atrial appendage orifice was classified into 3 types: oval type(95 cases, 88.0%), round type(8 cases, 7.4%), water-drop type(5 cases, 4.6%). Conclusions: TEE is an effective method to screen out left atrial appendage thrombosis patients in pre-operation of left atrial appendage occlusion which is better than CT, but CT examination provides more anatomical informations in pre-operation of left atrial appendage occlusion, so the combination of two examinations can provide more accurate support for the success of the operation.

Key words： Atrial appendage Echocardiography, transesophageal Tomography, spiral computed

收稿日期: 2016-05-05

PACS:	Ｒ541
	Ｒ540.45
	Ｒ814.42

通讯作者: 马小静，武汉亚洲心脏病医院超声中心，430022。E-mail：14307968@qq.com

作者简介: 余正春（1983-），男，安徽歙县人，主治医师。E-mail：cyy027@aliyun.com

引用本文:

余正春，马小静，夏娟，李菁. 经食道超声心动图及CT在左心耳封堵术前检查中的应用价值[J]. 中国临床医学影像杂志, 2017, 28(2): 105-108.
YU Zheng-chun, MA Xiao-jing, XIA Juan, LI Jing. The value of trans-esophageal echocardiography and CT in the pre-operation of left atrial appendage occlusion. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(2): 105-108.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I2/105

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