经食管超声心动图联合右心造影及卵圆孔三维重建技术在精准诊断卵圆孔未闭患者中的临床价值

Clinical Value of Transesophageal Echocardiography Combined with Right Cardiography and Three-Dimensional Reconstruction of Foramen Ovale in Accurate Evaluation of Patients with Patent Foramen Ovale

目的研究经食管超声心动图(transesophageal echocardiography,TEE)联合右心造影(contrast transthoracic echocardiography,cTTE)及卵圆孔三维重建技术在精准诊断卵圆孔未闭(patent foramen ovale,PFO)患者中的临床价值。方法回顾性分析从2021年5月到2023年2月在梅州市人民医院接受治疗的70例PFO患者的临床资料。所有患者均实施TEE检查、cTTE检查以及卵圆孔三维重建技术检查,比较各种检测方式检出率、联合检测的检出效能,以及cTTE分流量与TEE检测的相关性。结果cTTE共检测出57例PFO,检出率为81.43%,TEE共检测出58例PFO,检出率为82.86%;TEE联合cTTE对于PFO的诊断价值显著提高,其检出率为90.00%(63/70),而TEE+cTTE+三维重建对于PFO的诊断价值最高,其检出率为100.00%(70/70)。cTTE检测结果显示,cTTE分流量为大量者最多,达到34例,而TEE检测显示的PFO长径平均高达11.39 mm,PFO短径则平均达到6.11 mm,PFO宽径平均为1.58 mm。根据Spearman法分析相关性发现,TEE所测PFO的短径、长径、宽径与cTTE检测的分流等级均呈正相关(均P<0.05)。结论TEE联合cTTE及卵圆孔三维重建技术在精准诊断PFO中的临床价值较高,联合诊断检查的临床效果满意,值得推广。

Objectives To study the clinical value of transesophageal echocardiography(TEE)combined with right heart contrast transthoracic echocardiography(cTTE)and three-dimensional(3D)reconstruction of foramen ovale in the accurate evaluation of patients with patent foramen ovale(PFO).Methods Clinical data of 70 patients with PFO treated in Meizhou People′s Hospital from May 2021 to February 2023 were analyzed retrospectively in this study.TEE examination,cTTE examination and 3D reconstruction of foramen ovale were performed for all the patients.The detection rate of various detection methods and the detection efficiency of combined detection were compared,and the correlation between cTTE flow rate and TEE detection was analyzed.Results Fifty seven cases of PFO were detected in cTTE,the detection rate was 81.43%,and 58 cases of PFO were detected in TEE,the detection rate was 82.86%.TEE combined with cTTE significantly increased the diagnostic value of PFO,with a detection rate of 90.00%(63/70),while TEE+cTTE+3D reconstruction had the highest diagnostic value for PFO,with a detection rate of 100.00%(70/70).The results of cTTE test showed that the shunt volume of cTTE was the most abundant,reaching 34 cases,while the TEE test showed that the average length diameter of PFO was 11.39 mm and the average short diameter of PFO was 6.11 mm,while the average width diameter of PFO was 1.58 mm.According to the correlation of Spearman method,it was found that the short diameter and long diameter of PFO measured by TEE were positively correlated with the shunt grade of cTTE detection respectively(all P<0.05).Conclusions TEE,cTTE and 3D reconstruction of foramen ovale technology have high clinical value in accurate evaluation of patients with PFO,and the clinical effect of combined diagnostic examination is satisfactory,which is worth popularizing.