| 摘要: |
| 目的：探讨右心声学造影(c-TTE)及经颅多普勒发泡试验(c-TCD)对隐源性卒中患者并卵圆孔未闭(PFO)的诊断价值。方法：选取2020年1月～2022年12月在我院诊治的隐源性卒中患者102例,均行c-TCD及c-TTE检查,以经食管超声心动图(TEE)作为诊断金标准,比较c-TTE、c-TCD检查对隐源性卒中患者PFO的诊断价值。结果：TEE检查证实102例隐匿性卒中患者有44例PFO,c-TCD检查结果显示,真阳性36例,假阳性10例,假阴性8例,真阴性48例；c-TTE检查结果显示,真阳性42例,假阳性3例,假阴性2例,真阴性55例。受试者工作特征(ROC)曲线分析显示,c-TCD检查、c-TTE诊断隐匿性卒中患者PFO的AUC分别为0.823,0.951,c-TCD检查诊断隐源性卒中患者PFO的敏感度、特异度、准确率分别为81.82%、82.76%、82.35%,明显低于c-TTE检查的95.45%、94.83%、95.10%(P<0.05)。c-TCD检查对右向左分流半定量分级低于c-TTE(P<0.05),c-TCD检查对右向左分流的检出率为30.39%,明显低于c-TTE的58.82%(P<0.05)。结论：与c-TCD检查相比较,c-TTE对隐源性卒中患者PFO具有更高的诊断价值,且对隐源性卒中PFO患者的右向左分流半定量分级程度更高、检出率更高。 |
| 关键词: 右心声学造影 经颅多普勒发泡试验 隐源性卒中 卵圆孔未闭 诊断价值 右向左分流 |
| DOI： |
| 投稿时间：2023-02-27修订日期：2023-03-30 |
| 基金项目:广州市科信局计划项目，基金编号：201904010419 |
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| Evaluation of right ventricular contrast echocardiography and transcranial Doppler foaming test on patent foramen ovale in patients with cryptogenic stroke |
| wuting,zhangkunyan,yaojingyuan,liyingjia |
| () |
| Abstract: |
| Objective: To explore the diagnostic value of contrast-enhanced transesophageal echocardiography (c-TTE) and contrast-enhanced transcranial doppler (c-TCD) in patients with cryptogenic stroke with patent foramen ovale (PFO). Methods: 102 patients with cryptogenic stroke who were diagnosed and treated in our hospital from January 2020 to December 2022 were selected. All patients underwent c-TCD examination and right heart contrast echocardiography. Transesophageal echocardiography (TEE) was used as the diagnostic gold standard. The diagnostic value of right heart contrast echocardiography and c-TCD examination for PFO in patients with cryptogenic stroke was compared. Results: TEE examination confirmed 44 cases of PFO in 102 patients with concealed stroke. The results of c-TCD examination showed that 36 cases were true positive, 10 cases were false positive, 8 cases were false negative, and 48 cases were true negative; The results of c-TTE showed that there were 42 cases of true positive, 3 cases of false positive, 2 cases of false negative and 55 cases of true negative. The analysis of the working characteristic (ROC) curve of the subjects showed that the AUC of c-TCD and c-TTE in the diagnosis of PFO in patients with occult stroke were 0.823 and 0.951 respectively, and the sensitivity, specificity and accuracy of c-TCD in the diagnosis of PFO in patients with occult stroke were 81.82%, 82.76% and 82.35% respectively, which were significantly lower than 95.45%, 94.83% and 95.10% of c-TTE (P<0.05). The semi-quantitative grading of right-to-left shunt by c-TCD was lower than that of c-TTE (P<0.05), and the detection rate of right-to-left shunt by c-TCD was 30.39%, significantly lower than 58.82% of c-TTE (P<0.05). Conclusion: Compared with c-TCD, c-TTE has higher diagnostic value for cryptogenic stroke patients with PFO, and the degree of semi-quantitative grading of right-to-left shunt is higher and the detection rate is higher for cryptogenic stroke patients with PFO. |
| Key words: Contrast-enhanced transesophageal echocardiography Contrast-enhanced transcranial doppler For cryptogenic stroke Patent foramen ovale Diagnostic value Right to left shunt |
