经颅多普勒和经食道超声诊断卵圆孔未闭的对比观察

目的对门诊的偏头痛患者进行经颅多普勒超声（TCD）和经食道超声两项检查来诊断卵圆孔未闭，评估两者的优劣。方法经受试者同意后，选取我院神经内科门诊就诊的偏头痛患者41例，无先兆偏头痛15例，有先兆偏头痛26例，自肘前静脉注射手振生理盐水作为造影剂，并结合Valsava动作，进行经颅多普勒超声和经食道超声检测，诊断卵圆孔未闭。结果22例经颅多普勒超声和经食道超声检查两项均为阴性。16例两者均阳性，1例显示经食道超声阳性而经颅多普勒超声未发现微栓子信号。2例经颅多普勒超声阳性而经食道超声未发现卵圆孔未闭。结论经颅多普勒超声对卵圆孔未闭的检测具有高敏感性、高特异性，可作为怀疑卵圆孔未闭患者的筛查手段。

Comparison of transcranial contrast Doppler and transesophageal contrast echocardiography in the detection of patent foramen ovule in migrainer

Objective Tramesophageal echocardiography(TEE) and transcranial Doppler (TCD) examination with contrast injection can both be used to search for a patent foramen ovale(PFO).We compared the accuracy of these techniques for identifying a PFO in patients with migraine.Methods PFO was assessed by performing TEE and TCD with Ⅳ injection of agitated saline in 41 subjects with migraine with aura (n=26) and without aura (n=15) in Oct-patient department(OPD).Results We found 22 PFOs with both TCD and TEE.Both contrast tests were negative in 16 patients.For 1 patient,the contrast test was positive only with TEE.And 2 were positive only in TCD.In comparison with TEE,adopted as the "gold standard",TCD had a sensitivity of 94% (16 0f 17),specificity of 92% (17 of 18).Conclusions cTCD is an examination with wish sensitivity and high specificity in detectins a PFO.