主动脉窦瘤破裂的超声诊断研究进展

主动脉窦瘤破裂在临床并不常见,但其预后凶险不易控制,一旦明确诊断,应立即通过手术封堵缺口,纠正血流动力学异常。因此,积累该病的诊断经验以提高诊断准确率、缩短确诊时长、为尽早手术争取时间意义重大。经胸超声心动图作为该病的首选检查手段有其明确的特征性诊断依据,经食道超声心动图、实时三维超声成像系统在介入封堵术的术前准备及术中引导方面起着不可或缺的关键作用,术后长期随访复诊中判定封堵器的稳定性、周边有无异常反流及评价心脏整体血流动力学情况、评估预后的过程也对超声心动技术十分依赖。超声影像技术及其他相关科学技术的发展,让我们对该病有了新的认识,从而为快速诊断、鉴别乃至治疗术式都提供了更多的选择。本文将从超声在主动脉窦瘤破裂的术前诊断、术中引导及术后评估方面的研究进展作一综述。

Research progress in ultrasonic diagnosis of ruptured aneurysm of aortic sinus

Rupture aneurysm of aortic sinus is not common clinically.However,it is difficult to control the prognosis of rupture.Once the diagnosis is clear,it is necessary to close the gap by operation immediately and correct the hemodynamic abnormality.Therefore,it is of great significance to accumulate the diagnosis experience of this disease so as to improve the diagnostic accuracy,shorten the length of diagnosis and make time for early operation.Transthoracic echocardiography has its definite characteristic diagnosis basis and has become the preferred examination method of this disease.Transesophageal echocardiography and real-time three-dimensional ultrasound imaging system play an indispensable role in preoperative preparation and intraoperative guidance of interventional occlusion.The process of determining the stability of the occlusive device,whether there is abnormal regurgitation in the periphery,evaluating the overall hemodynamics of the heart and evaluating the prognosis during long-term follow-up is also very dependent on echocardiography.With the development of ultrasound technology and related technologies,we have a new understanding of this disease,thus providing more choices for rapid diagnosis,differential diagnosis and treatment.In this paper,we will review the research progress of ultrasound in preoperative diagnosis,intraoperative guidance and postoperative evaluation of ruptured aneurysm of aortic sinus.