经食管超声心动图造影与经颅多普勒声学造影诊断新发脑卒中患者卵圆孔未闭的对比研究

Comparation of contrast transesophageal echocardiography and contrast transcranial doppler echocardiography in detection of patent foramen ovale in recent stroke

目的比较经食管超声心动图造影(cTEE)与经颅多普勒声学造影(cTCD)检测脑卒中患者卵圆孔未闭的效果。方法2018年6月至2019年6月新发脑卒中患者180例,其中男105例,女75例,年龄45~65(55±10)岁。所有患者分别于静息状态及乏氏动作时行cTEE及cTCD检查,探测未闭的卵圆孔,对比两种方法的卵圆孔未闭检出率及心脏右向左分流情况。结果静息状态下cTCD的卵圆孔未闭检出率为44.4%(80/180),cTEE的检出率为80.6%(145/180)。乏氏动作下,cTCD的卵圆孔未闭检出率为80.0%(144/180),cTEE为94.4%(170/180)。卵圆孔未闭检出率及≥3级的右向左分流占比cTEE检测显著高于cTCD检测(P<0.05),乏氏动作下均显著高于静息状态下(P<0.05)。结论对于新发脑卒中患者的卵圆孔未闭检测,cTEE优于cTCD,乏氏动作有助于提高卵圆孔未闭检出率。

Objective To compare contrast transesophageal echocardiography(cTEE)with contrast transcranial doppler echocardiography(cTCD)in detection of patent foramen ovale(PFO)in patients with recent stroke.Methods 180 patients with recent stroke were enrolled from June 2018 to June 2019.cTEE and cTCD were performed at rest state and during Valsalva maneuver to detect PFO.The detection rate of PFO and right to left shunt(RLS)were compared between the two methods.Results The detection rate of PFO was 44.4%in cTCD examination and 80.6%in cTEE examination at rest state,and 80.0%and 94.4%,respectively,during Valsalva maneuver.The detection rate of PFO and the ratio of RLS≥class III were significantly higher in cTEE examination than in cTCD examination,and during Valsalva maneuver than at rest state(all P<0.05).Conclusion cTEE examination is superior to cTCD examination for detection of PFO in patients with recent stroke and Valsalva maneuver may increase the detection rate of PFO.