主动脉夹层经胸超声心动图漏诊及误诊原因分析

摘要：目的：探讨主动脉夹层超声表现及部分病例漏诊误诊原因。方法：收集经手术证实为主动脉夹层诊断的病例50例进行回顾分析。结果：手术证实升主动脉夹层36处，主动脉弓夹层29处，降主动脉夹层43处。超声心动图对降主动脉病变漏诊16处，对主动脉弓病变漏诊9处，对升主动脉处病变漏诊1处。漏诊导致对主动脉夹层Debakey分型错误，I型夹层误诊16例，II型夹层误诊0例，III型夹层误诊1例。结论：主动脉夹层漏诊数量由高至低依次为降主动脉、主动脉弓、升主动脉，漏诊及误诊与超声医师因素、超声图像及设备因素密切相关。

Missed diagnosis and misdiagnosis of aortic dissection through transthoracic echocardiography

Objective: To investigate the ultrasound findings of aortic dissection and its causes of misdiagnosis and miss-diagnosis. Methods: A retrospective analysis was conducted in 50 cases of aortic dissection confirmed by surgery or autopsy. Results: Totally 36 ascending aortic dissections, 29 aortic arch dissections, and 43 descending aortic dissections were confirmed by surgery. Echocardiography missed 16 of the descending aortic lesions, 9 of the aortic arch lesions, and 1 of the ascending aortic lesions. Misdiagnosis resulted in incorrect Debakey typing of the aortic dissection. Among them, 16 cases were misdiagnosed with type I dissection and 1 case was misdiagnosed with type III dissection. ?Conclusion: The number of missed diagnosis of aortic dissection is descending aorta, aortic arch, and ascending aorta in order from high to low. The misdiagnosis and miss-diagnosisof aortic dissection may be related to the experienceof sonographer, ultrasound image and ultrasound equipment.