超声心动图联合右心声学造影在卵圆孔未闭诊断中的价值探讨

The value of echocardiography combined with right echocardiography in the diagnosis of Patent foramen ovale

目的:探讨经食道超声心动图(transesophageal echocardiography,TEE)、右心声学造影(contrast transthoracic echocardiography,cTTE)在卵圆孔未闭(patent foramen ovale,PFO)诊断中的应用价值。方法:本研究选取2019年8月—2020年10月运城市中心医院收治的121例疑似PFO患者作为研究对象,所有患者均进行TEE、cTTE两种检查,对TEE、cTTE两种检查手段单独或联合检查用于PFO诊断的检出率、右向左分流(right to left shunt,RLS)检出率进行对比分析。结果:121例疑似PFO患者经TEE检查发现112例PFO,检出率为92.56%(112/121);经cTTE检查发现120例PFO,检出率为99.17%(120/121);TEE、cTTE联合检查发现121例PFO,检出率为100.00%(121/121)。cTTE对PFO的检出率显著高于TEE检查(P<0.05);TEE、cTTE联合检查对P F O的检出率显著高于TEE单独检查(P<0.05),与cTTE单独检查比较差异不显著(P>0.05)。cTTE对RLS的检出率显著高于TEE检查(P<0.05)。结论:与TEE单独检查相比,cTTE对PFO的检出率显著提升,且与TEE联合cTTE对PFO的检出率相当;cTTE能较好地反映RLS情况,可在临床借鉴推广。

Objective The esophageal echocardiography(TEE)and the contrast transthoracic echocardiography were investigated.Application value of cTTE in patent foramen ovale(PFO)diagnosis.Methods In this study,121 suspected PFO patients admitted to our hospital from August 2019 to October 2020 were selected as the research objects.All patients underwent TEE and cTTE tests.The detection rate of TEE and cTTE alone or in combination for PFO diagnosis and the detection rate of right to left shunt(RLS)were compared and analyzed.Results 112 cases of PFO were found by TEE examination in 121 suspected PFO patients,the detection rate was 92.56%(112/121).120 cases of PFO were found by cTTE examination,and the detection rate was 99.17%(120/121).TEE and cTTE combined examination revealed 121 cases of PFO,with a detection rate of 100.00%(121/121).The detection rate of PFO by cTTE was significantly higher than that by TEE(P<0.05),and the detection rate of PFO by TEE and cTTE combined examination was significantly higher than that by TEE alone(P<0.05),but there was no significant difference between cTTE and TEE alone(P>0.05).The detection rate of RLS by cTTE was significantly higher than that by TEE(P<0.05).Conclusion Compared with TEE alone,the detection rate of PFO by cTTE was significantly improved,and was similar to that by TEE combined with cTTE.cTTE can better reflect the situation of RLS,which can be used for reference and promotion in clinical practice.