cTCD、cTTE、cTEE对卵圆孔未闭右向左分流的诊断价值

Diagnostic value of cTCD,cTTE and cTEE in right⁃to⁃left shunt of patent foramen ovale

目的 分析研究经颅多普勒超声声学造影(cTCD)、经胸超声心动图声学造影(c TTE)、经食管超声心动图声学造影(cTEE)对卵圆孔未闭(PFO)右向左分流(RLS)的诊断价值。方法 选取2020年1月至2022年12月安阳市人民医院收治的216例疑似PFO-RLS患者作为研究对象,所有患者均接受cTCD、c TTE、cTEE检查,以经食管超声心动图检查(TEE)作为诊断的“金标准”,分析cTCD、cTTE、cTEE对PFO-RLS的诊断效能。结果 TEE检查PFO-RLS的阳性率为94.44%(204/216);以TEE的诊断结果作为“金标准”,cTCD诊断的敏感性和特异性分别为89.71%、66.67%;cTTE诊断的敏感性和特异性分别为95.59%、75.00%;cTEE诊断的敏感性和特异性分别为99.02%、83.33%。cTEE诊断的敏感性与准确性高于cTCD,差异有统计学意义(χ^(2)=5.181、4.995,P<0.05);cTEE诊断的敏感性与准确性高于cTTE,差异有统计学意义(χ^(2)=4.578、4.514,P<0.05);c TTE诊断的敏感性与准确性高于c TCD,差异有统计学意义(χ^(2)=16.633、16.301,P<0.05)。结论 c TCD、c TTE、cTEE均可诊断PFO-RLS,cTEE的诊断价值最高。

Objective To analyze the diagnostic value of contrast transcranial Doppler ultrasonog-raphy(cTCD),contrast transthoracic echocardiography(cTTE)and contrast transesophageal echocardiogra-phy(cTEE)in right-to-left shunt(RLS)of patent foramina ovale(PFO).Methods A total of 216 suspected PFO-RLS patients were admitted to Anyang City Peoples Hospital from January 2020 to December 2022 and were selected as the subobjects of this study.All patients underwent cTCD,cTTE and cTEE examinations,with transesophageal echocardiography(TEE)being used as the“gold standard”for diagnosis.The diagnostic efficiency of cTCD,cTTE and cTEE for PFO-RLS was analyzed.Results The positive rate of PFO-RLS de-tected by TEE was 94.44%(204/216).Using TEE as the“gold standard”,the sensitivity and specificity of cTCD diagnosis were 89.71%and 66.67%,respectively.The sensitivity and specificity of cTTE diagnosis were 95.59%and 75.00%,respectively.The sensitivity and specificity of cTEE diagnosis were 99.02%and 83.33%,respectively.The diagnostic sensitivity and accuracy of cTEE were higher than those of cTCD,and the differences were statistically significant(χ^(2)=5.181,4.995,P<0.05).The diagnostic sensitivity and accura-cy of cTEE were also higher than that of cTTE,and the differences were statistically significant(χ^(2)=4.578,4.514,P<0.05).Additionally,the diagnostic sensitivity and accuracy of cTTE were higher than those of cTCD,and the differences were statistically significant(χ^(2)=16.633,16.301,P<0.05).Conclusion cTCD,cTTE and cTEE candiagnose PFO-RLS,but cTEE offers the highest diagnostic value.