规范化Valsalva动作在经胸右心声学造影筛查PFO中的应用价值

Application Value of Standardized Valsalva Maneuver in the Screening of PFO by Contrast Transthoracic Echocardiography

目的探讨规范化Valsalva动作在经胸右心声学造影(contrast transthoracic echocardiography,cTTE)筛查卵圆孔未闭(patent foramen ovale,PFO)中的影响及意义。方法对在cTTE中的Valsalva动作规范化改进前后期间,临床疑为PFO并在中国人民解放军陆军军医大学新桥医院超声科行cTTE检查及经食管超声心动图检查(transesophageal echocardiography,TEE)的患者的检查资料进行回顾性分析,将Valsalva动作规范化改进前的150例患者的检查资料纳入对照组,改进后的161例患者的检查资料纳入改进组,对各组的cTTE和TEE结果行一致性检验,并比较两组cTTE对PFO所致右向左分流的检出敏感度、特异性。结果改进组中cTTE对PFO的检出敏感度较对照组显著提高(P<0.05),其检出能力与TEE有较好的一致性。结论Valsalva动作的规范化执行能提升cTTE对PFO的检出敏感度,降低漏诊事件的发生。

Objective To investigate the effect and significance of standardized Valsalva maneuver in the screening of patient with patent foramen ovale(PFO)by contrast transthoracic echocardiography(cTTE).Methods Review the examination data of the patients with clinical suspected PFO who underwent cTTE examination and transesophageal echocardiography(TEE)in our department before and after the standardization of Valsalva maneuver in cTTE examination.The examination data of 150 patients before the improvement of Valsalva maneuver standardization were included in the control group,and the examination data of 161 patients after the improvement of Valsalva maneuver standardization were included in the improvement group.The consistency test of cTTE and TEE results in each group was conducted,and the sensitivity and specificity of cTTE in the detection of a right-to-left shunt caused by PFO were compared between the two groups.Results The detection sensitivity of cTTE to PFO in the improved group was significantly higher than that in the control group(P<0.05),and its detection ability was better consistent with TEE.Conclusion The standardized execution of Valsalva maneuver can improve the detection sensitivity of cTTE to PFO and reduce the occurrence of missed diagnosis events.