ENHANCED DETECTION OF INTRACARDIAC SOURCES OF CEREBRAL EMBOLI BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY
ENHANCED DETECTION OF INTRACARDIAC SOURCES OF CEREBRAL EMBOLI BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY
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DOI：
10.1161/01.str.22.6.734
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发表时间：
1991-06-01
期刊：
影响因子：
8.3
通讯作者：
SCHNITTGER, I
中科院分区：
文献类型：
--
作者：
LEE, RJ;BARTZOKIS, T;SCHNITTGER, I
我们对 50 名最近发生短暂性脑缺血发作或栓塞源性卒中的连续住院患者进行了经食管超声心动图检查，以确定经食管超声心动图在检测可能的心内栓塞来源方面是否比经胸超声心动图更敏感。 50 名经胸超声心动图显示可能存在栓子来源的患者中，有 26 名患者进行了经食管超声心动图研究，结果显示至少有一个心内异常。经食管超声心动图发现的异常包括 50 名患者中的 5 名患有左心房或左心耳血栓，4 名患者患有卵圆孔未闭，9 名患者患有自发超声心动图造影。在 50 名没有其他栓塞来源的患者中，有 11 名患者在二尖瓣上发现了高度活动的丝状束，这在以前没有被描述过。这些二尖瓣回声链可能代表裂隙表面或纤维化，可作为血栓形成的病灶。我们没有发现意外的左心室血栓或左心房粘液瘤。与经食管超声心动图检查结果呈阳性的可能性显着相关的因素包括左心房扩大、心房颤动以及二尖瓣钙化或增厚。我们的研究表明，在调查潜在的心内栓塞来源时，经食管超声心动图是经胸超声心动图的一个有价值的补充。
We performed transesophageal echocardiography in 50 consecutive hospitalized patients with recent transient ischemic attack or stroke of embolic origin to determine whether transesophageal echocardiography is more sensitive than transthoracic echocardiography in detection of possible intracardiac sources of embolism. Twenty-six of 50 patients with a negative transthoracic echocardiogram for potential source of emboli had a transesophageal echocardiography study that demonstrated at least one intracardiac abnormality. Abnormalities noted by transesophageal echocardiography included five of 50 patients with either a left atrial or left atrial appendage clot, four patients with a patent foramen ovale, and nine patients with spontaneous echocardiographic contrast. In 11 of 50 patients with no other source of embolism, we found highly mobile filamentous strands on the mitral valve, which have not been described previously. These mitral valve echo strands may represent a fissured surface or fibrosis that can serve as a nidus for thrombus formation. We detected no unexpected left ventricular thrombus or left atrial myxoma. Factors significantly associated with a greater likelihood of a positive transesophageal echocardiography study included left atrial enlargement, atrial fibrillation, and a calcified or thickened mitral valve. Our study suggests that transesophageal echocardiography is a valuable addition to transthoracic echocardiography in investigating potential intracardiac sources of embolism.