经颅多普勒超声造影在不明原因偏头痛及脑梗塞患者卵圆孔未闭中的诊断价值

Diagnostic value of contrast transcranial Doppler ultrasound in patent foramen ovale in patients with unexplained migraine and cerebral infarction

目的探讨经颅多普勒超声造影(c-TCD)对不明原因偏头痛及脑梗塞患者卵圆孔未闭(PFO)的诊断价值。方法选择我院收治的80例不明原因偏头痛及脑梗塞患者为研究对象,患者均行c-TCD和经食道超声心动图(TEE),以数字减影血管造影结果为金标准,比较c-TCD与TEE在不明原因偏头痛及脑梗塞患者PFD中的诊断价值。结果 53例患者经数字减影血管造影检查确诊为PFO。c-TCD检测PFO的灵敏度高于TEE(P<0.05);两种方法检测PFO的特异度比较,差异无统计学意义(P>0.05)。c-TCD检查中微泡中位数排在前两位的分别为坐位与右侧卧位,不同体位下微泡数量比较,差异具有统计学意义(P<0.05)。结论c-TCD对PFO的诊断灵敏度高,其能提高微泡检出率,为临床诊疗提供依据和参考,值得临床推广应用。

Objective To investigate the diagnostic value of contrast transcranial Doppler ultrasound(c-TCD)in patent foramen ovale(PFO)in patients with unexplained migraine and cerebral infarction.Methods Eighty patients with unexplained migraine and cerebral infarction admitted to our hospital were selected as the study objects.All patients underwent c-TCD and transesophageal echocardiography(TEE).The digital subtraction angiography were selected as the gold standard.The diagnostic value of c-TCD and TEE in PFO in patients with unexplained migraine and cerebral infarction were compared.Results A total of 53 patients were diagnosed as patent foramen ovale by digital subtraction angiography.The sensitivity of c-TCD in the detection of PFO was higher than that of TEE(P<0.05).There was no significant difference in specificity in the detection of PFO between the two methods(P>0.05).The median of microbubbles in sitting position and right lateral position detected by c-TCD ranked the first and second positions.There were significant differences in the number of microbubbles in different postures(P<0.05).Conclusion c-TCD has high sensitivity in the diagnosis of PFO.It can improve the detection rate of microbubbles and provide basis and reference for clinical diagnosis and treatment.It is worthy of clinical promotion and application.