The clinical value of echocardiography combined with transabdominal vascular ultrasound in the diagnosis of different types of aortic dissection

Abstract

Purpose: To analyze the clinical values of echocardiography combined with vascular ultrasound in the diagnosis of aortic dissection according to the DeBakey classification.

Methods: The clinical data of 77 patients with aortic dissection admitted to our hospital from August 2016 to January 2022 were retrospectively analyzed. All patients were examined with ultrasound and CT angiography (CTA), the consistency between ultrasound and CTA ± intraoperative diagnosis for the classification of AD was checked, as well as the differences in ultrasound signs and Ultrasound parameters between different types of AD were analyzed.

Results: The results of Kappa value: There was a high level of agreement between echocardiography combined with transabdominal vascular ultrasound and CTA ± intraoperative diagnosis for the classification of AD (Kappa = 0.897, p = 0.000). In the ultrasound signs, the proportion of pericardial effusion, aortic regurgitation, aortic widening, and coronary artery involvement in type DeBakey I and II aortic dissection was significantly higher than that in Type III. There was no significant difference in the proportion of intimal floating, true and false lumen, and intimal rupture in Types I, II, and III aortic dissections. In the comparison of ultrasound parameters, there is a statistically significant difference in the values of LAD (left atrial diameter), LAV (left atrial volume), and LVEDD (left ventricular end-diastolic diameter) among different types of aortic dissection. There is no significant difference in IVS (interventricular septum thickness), LVPW (left ventricular posterior wall thickness), LVEF (left ventricular ejection fraction), and E/e' ratio among different types of aortic dissection.

Conclusion: Echocardiography combined with transabdominal vascular ultrasound can accurately evaluate aortic dissection with real-time dynamic images and provide important clinical significance for early individualized treatment of patients through accurate classification of different aortic dissection.

Keywords: CT angiography; DeBakey typing; aortic dissection; echocardiography; transabdominal vascular ultrasound.