经胸超声心动图声学造影与经颅多普勒超声声学造影同步试验对卵圆孔未闭的诊断价值

目的:探讨经胸超声心动图声学造影(cTTE)与经颅多普勒超声声学造影(cTCD)同步试验对卵圆孔未闭(PFO)的诊断价值。方法:选取我院疑似PFO患者769例,其中在静息和Valsalva动作下行cTTE 298例、cTTE与cTCD同步试验471例。以经食道超声心动图(TEE)为PFO的诊断标准,分析cTTE与cTCD同步试验对PFO的诊断价值。结果:共纳入769例患者,其中Valsalva动作下PFO阳性263例(34.2%)。298例患者行cTTE检查,静息时PFO阳性30例(10.1%),Valsalva动作下PFO阳性104例(34.9%),Valsalva动作下PFO阳性率较静息时显著提高(P<0.05)。471例患者行cTTE与cTCD同步试验,静息时PFO阳性50例(10.6%),Valsalva动作下PFO阳性159例(33.7%),Valsalva动作下PFO阳性率较静息时显著提高(P<0.05)。以TEE为PFO确诊标准,Valsalva动作下cTTE诊断PFO的准确性为87.5%(40/44),cTTE与cTCD同步实验诊断PFO的准确性为95.2%(40/42)。结论:cTTE与cTCD同步试验能提高PFO的诊断价值,尤其是Valsalva动作下PFO阳性率明显提高;cTTE与cTCD同步试验较cTTE诊断准确性提高。

Diagnostic Value of Synchronous Test of Contrast Transthoracic Echocardiography and Contrast Transcranial Doppler Ultrasonography in Patients With Patent Foramen Ovale

Objectives:To evaluate the diagnostic value of synchronous test of contrast transthoracic echocardiography(cTTE)and contrast transcranial Doppler ultrasonography(cTCD)in patients with patent foramen ovale(PFO).Methods:769 patients admitted in our hospital with suspected PFO were included in this study,298 patients performed cTTE with or without Valsalva maneuver,471 patients performed the synchronous test of cTTE and cTCD.Transesophageal echocardiography(TEE)was used as the diagnostic criteria for PFO to analysis the diagnostic value of synchronous test with cTTE and cTCD in defining PFO.Results:263 cases were PFO positive(34.2%)with Valsalva maneuver.Among the 298 cases of cTTE,30 cases were PFO positive at rest(10.1%),104 cases were PFO positive with Valsalva maneuver(34.9%),the positive PFO rate of cTTE with Valsalva maneuver was significantly higher than that at rest(P<0.05).Among 471 cases of cTTE,50 cases was PFO positive at rest(10.6%),159 cases were PFO positive with Valsalva maneuver(33.7%),the positive PFO detection rate post cTTE and cTCD synchronous test with Valsalva maneuver was significantly higher than that at rest(P<0.05).TEE was used as the golden diagnostic criteria for PFO,the diagnostic accuracy of PFO was 87.5%(40/44)in cTTE with Valsalva maneuver,was 95.2%(40/42)in the synchronous test of cTTE and cTCD with Valsalva maneuver.Conclusions:The synchronous test of cTTE and cTCD with Valsalva maneuver can increase the diagnostic rate of PFO.The diagnostic accuracy of PFO is significantly higher by synchronous test of cTTE and cTCD with Valsalva maneuver than cTTE alone.