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目的探讨经食管超声心动图(TEE)在左心耳(LAA)大小、分叶及形态分析中的应用价值。方法 135例患者行TEE检查,男79例,女56例,年龄(53.7±19.1)岁,由2位观察者对LAA开口最大径、深度、分叶、形态进行单盲测量。结果 2位观察者测量LAA开口最大径分别为(18.8±3.6)mm、(19.8±3.4)mm,深度为(28.2±5.6)mm、(29.2±5.2)mm,均具有统计学差异,经Bland-Altman分析TEE观察者之间一致性较好。128例可观察LAA分叶,1叶47例、2叶63例、三叶13例、多叶5例,分别占36.7%、49.2%、10.2%、3.9%。127例LAA中鸡翅型44例,仙人掌型31例,风向袋型29例,菜花型23例,分别占34.7%、24.4%、22.8%、18.1%。结论二维多平面TEE对LAA的大小、分叶及解剖形态的分析具有准确度及可重复性。
Objective To investigate the value of transesophageal echocardiography (TEE) in the analysis of size, lobulation and morphology of left atrial appendage (LAA). Methods TEE was performed in 135 patients. There were 79 males and 56 females, aged 53.7 ± 19.1 years old. Two observers performed single-blind measurement on the maximum diameter, depth, lobulation and morphology of LAA. Results The maximal diameters of LAA opening measured by two observers were (18.8 ± 3.6) mm and (19.8 ± 3.4) mm, respectively, with a depth of (28.2 ± 5.6) mm and (29.2 ± 5.2) mm, respectively. -Altman better agreement between TEE observers. 128 cases were observed LAA lobes, 47 cases of 1 leaf, 63 cases of 2 leaves, 13 cases of clover, 5 cases of multi-lobe, accounting for 36.7%, 49.2%, 10.2% and 3.9% respectively. There were 44 chicken wings, 31 cactus species, 29 wind direction type and 23 cauliflower type in LAA, accounting for 34.7%, 24.4%, 22.8% and 18.1% respectively. Conclusion Two-dimensional multiplanar TEE has the accuracy and repeatability for the analysis of LAA size, lobulation and anatomy.