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目的比较经食管超声心动图和经胸超声心动图在心源性栓塞性脑梗死(cardio-embolic cerebral infarction,CECI)诊断中的价值。方法 57例隐源性脑梗死患者,均行经食管超声心动图和经胸超声心动图检查,比较2种方法对CECI的检出率。结果经胸超声心动图检出CECI 7例(12.3%),其中主动脉粥样硬化斑块2例为高危性CECI,卵圆孔未闭2例、二尖瓣增厚2例、二尖瓣脱垂1例为低危性CECI,未发现房间隔缺损、左心房自发声学影像;经食管超声心动图检出CECI 22例(38.6%),其中主动脉粥样硬化斑块2例为高危性CECI,卵圆孔未闭2例、二尖瓣增厚2例、二尖瓣脱垂7例、房间隔缺损5例、房间隔膨出瘤3例、左心房自发声学影像1例为低危性CECI;经食管超声心动图对CECI的检出率高于经胸超声心动图(P<0.05)。结论与经胸超声心动图比较,经食管超声心动图在CECI诊断中更具优势。
Objective To compare the value of transesophageal echocardiography and transthoracic echocardiography in the diagnosis of cardio-embolic cerebral infarction (CECI). Methods Fifty-seven patients with cryptogenic cerebral infarction underwent transesophageal echocardiography and transthoracic echocardiography. The detection rates of CECI by two methods were compared. Results There were 7 cases of CECI (12.3%) by transthoracic echocardiography. Among them, 2 cases of aortic atherosclerosis were high risk CECI, 2 cases of patent foramen ovale, 2 cases of mitral valve thickening, 2 cases of mitral valve One case of prolapse was low-risk CECI, no atrial septal defect and left atrial spontaneous acoustic imaging were found. CECI was detected in 22 cases (38.6%) by transesophageal echocardiography, in which 2 cases of aortic atherosclerosis were high risk CECI, patent foramen ovale in 2 cases, mitral valve thickening in 2 cases, mitral valve prolapse in 7 cases, atrial septal defect in 5 cases, atrial septal tumor in 3 cases, left atrial spontaneous acoustic imaging in 1 case Sex CECI; The detection rate of CECI by transesophageal echocardiography was higher than transthoracic echocardiography (P <0.05). Conclusion Compared with transthoracic echocardiography, transesophageal echocardiography has more advantages in CECI diagnosis.