Valsalva状态下卵圆孔未闭的超声与声学造影诊断价值及检出率研究

Study on the diagnostic value and detection rate of patent foramen ovale underValsalva maneuver by ultrasound and contrast echocardiography

目的 探讨经胸超声心动图、经胸右心声学造影对卵圆孔未闭(PFO)的临床诊断价值及Valsalva状态对PFO检出率的影响。方法 回顾性分析2021年3月至2023年1月在该院就诊的可疑PFO患者395例的影像资料。所有患者均接受经胸超声心动图、静息状态及Valsalva状态下经胸右心声学造影检查。结果 患者经胸右心声学造影PFO检出率高于经胸超声心动图,Valsalva状态下经胸右心声学造影PFO检出率高于静息状态下经胸右心声学造影,差异均有统计学意义(P<0.05)。Valsalva状态下经胸右心声学造影检出PFO患者的右至左分流分级高于静息状态下经胸右心声学造影,差异有统计学意义(P<0.05)。Valsalva状态下经胸右心声学造影右心房完全显影后左心房手振加血激活生理盐水造影剂显影所需心动周期数小于静息状态下经胸右心声学造影,差异有统计学意义(P<0.05)。结论 右心声学造影及Valsalva状态有助于PFO的检出。

Objective To investigate the clinical diagnostic value of transthoracic echocardiography(TTE)and transthoracic right heart contrast echocardiography(RHCE)for patent foramen ovale(PFO)and the effect of Valsalva maneuver on the detection rate of PFO.Methods A retrospective analysis was conducted on the imaging data of 395 patients with suspected PFO who visited this hospital from March 2021 to January 2023.All patients underwent TTE,RHCE in resting state,and RHCE under Valsalva maneuver.Results The detection rate of PFO by RHCE was higher than that by TTE,and the detection rate of PFO by RHCE under Valsalva maneuver was higher than that in resting state,with statistically significant differences(P<0.05).The grade of right-to-left shunt detected by RHCE under Valsalva maneuver was higher than that in resting state,with a statistically significant difference(P<0.05).The number of cardiac cycles required for the left atrium to become visible after the right atrium was fully visualized with agitated saline contrast in RHCE under Valsalva maneuver was smaller than that in resting state,with a statistically significant difference(P<0.05).Conclusion RHCE and Valsalva maneuver are helpful in the detection of PFO.