Evaluation of Pericardial Thickening and Adhesion Using High-Frequency Ultrasound
Evaluation of Pericardial Thickening and Adhesion Using High-Frequency Ultrasound
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DOI：
10.1016/j.echo.2023.03.010
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发表时间：
2023-08-02
影响因子：
6.5
通讯作者：
Huang, Xinsheng
中科院分区：
文献类型：
--
作者：
Lin, Jiadong;Li, Ming;Huang, Xinsheng
背景资料：使用标准频率超声探头的常规超声心动图的空间分辨率不足以清楚地显示壁层心包（PP）。高频超声（HFU）具有增强的轴向分辨率。本研究的目的是使用市售的高频线性探头来评估正常心包和心包疾病的心尖PP厚度（PPT）和心包粘连。方法：从2002年4月到2022年3月，227名健康个体，205例心尖动脉瘤（AA）和80例慢性缩窄性心包炎（CP）患者参加了这项研究。所有受试者均接受了标准频率超声和HFU，以成像心尖PP（APP）和心包粘连。结果：用高频超声测量心尖部PPT，发现PPT为0.60± 0.01mm正常对照组0.37- 0.87mm，PLUSMN组1.22 ~ 0.04mm AA组平均直径为0.48- 4.53mm，CP组平均直径为0.17mm（1.13- 9.01mm）。在39.2%的正常人中观察到微小的生理性积液。在69.8%的AA所致局部心包炎患者和97.5%的CP患者中检测到心包粘连。在6例CP患者中观察到明显增厚的心包脏层。在CP患者中，通过HFU获得的心尖PPT测量值与通过CT获得的测量值相关性良好。然而，CT仅能清晰显示45%的正常人和37%的AA患者的APP。在10例CP，HFU和CT表现出同等的能力，可视化非常增厚的APP.Conclusions：在正常对照组中使用HFU测量的心尖PPT范围为0.37至0.87毫米，符合以前的报告尸检研究。高频超声在鉴别AA局部心包炎与正常人方面具有较高的分辨率。HFU对APP病变的成像上级优于CT，因为CT在一半以上的正常人和AA患者中均未能显示APP。在我们的研究中，所有80例CP患者的APP均显著增厚，这一事实对先前报道的18% CP患者PPT正常的发现提出了质疑。
Background: Routine echocardiography using a standard-frequency ultrasound probe has insufficient spatial resolution to clearly visualize the parietal pericardium (PP). High-frequency ultrasound (HFU) has enhanced axial resolution. The aim of this study was to use a commercially available high-frequency linear probe to eval-uate apical PP thickness (PPT) and pericardial adhesion in both normal pericardium and pericardial diseases.Methods: From April 2002 to March 2022, 227 healthy individuals, 205 patients with apical aneurysm (AA) and 80 patients with chronic constrictive pericarditis (CP) were recruited to participate in this study. All subjects underwent both standard-frequency ultrasound and HFU to image the apical PP (APP) and pericardial adhe-sion. Some subjects underwent computed tomography (CT).Results: Apical PPT was measured using HFU and found to be 0.60 & PLUSMN; 0.01 mm (0.37-0.87 mm) in normal con-trol subjects, 1.22 & PLUSMN; 0.04 mm (0.48-4.53 mm) in patients with AA, and 2.91 & PLUSMN; 0.17 mm (1.13-9.01 mm) in pa-tients with CP. Tiny physiologic effusions were observed in 39.2% of normal individuals. Pericardial adhesion was detected in 69.8% of patients with local pericarditis due to AA and 97.5% of patients with CP. Visibly thickened visceral pericardium was observed in six patients with CP. Apical PPT measurements obtained by HFU correlated well with those obtained by CT in those patients with CP. However, CT could clearly visu-alize the APP in only 45% of normal individuals and 37% of patients with AA. In 10 patients with CP, both HFU and CT demonstrated equal ability to visualize the very thickened APP.Conclusions: Apical PPT measured using HFU in normal control subjects ranged from 0.37 to 0.87 mm, consistent with previous reports from necropsy studies. HFU had higher resolution in distinguishing local peri-carditis of the AA from normal individuals. HFU was superior to CT in imaging APP lesions, as CT failed to visu-alize the APP in more than half of both normal individuals and patients with AA. The fact that all 80 patients with CP in our study had significantly thickened APP raises doubt regarding the previously reported finding that 18% of patients with CP had normal PPT.