四种超声检查方法对卵圆孔未闭诊断价值的比较  

Comparison of four ultrasonographic methods in diagnosis of patent foramen ovale

作　　者：左思阳 ZUO Siyang(Department of Ultrasound Diagnosis,the 940th Hospital of Joint Logistics Support Force of PLA,Lanzhou 730050,China)

机构地区：[1]解放军联勤保障部队第940医院超声诊断科,兰州730050

出　　处：《武警医学》2022年第10期873-876,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 比较经胸超声心动图、经胸超声心动图联合右心声学造影、经食管超声心动图、经食管超声心动图联合右心声学造影四种检查方法对卵圆孔未闭(PFO)诊断的应用价值。方法 收集联勤保障部队第940医院2020-12至2021-11临床疑似PFO和经颅多普勒超声声学造影阳性患者87例为研究对象,所有患者同时行经胸超声心动图(TTE)、经胸超声心动图联合右心声学造影(c-TTE)、经食管超声心动图(TEE)和经食管超声心动图联合右心声学造影(c-TEE)检查,比较不同方法的PFO检出率,分析各自优缺点。结果 87例中,c-TEE检出PFO 71例(检出率81.61%),TEE检出PFO 56例(检出率64.37%),c-TTE检出PFO 47例(检出率54.02%),TTE检出PFO 23例(检出率为26.44%),四组之间差异有统计学意义(P<0.05)。c-TEE组阳性检出率高于c-TTE组(P<0.05),而c-TTE与TEE两组间阳性检出率差异无统计学意义(P=0.165)。Valsalva动作后,c-TEE组阳性检出率高于c-TTE组(P<0.05)。结论 四种方法比较,c-TEE、c-TTE、TEE对PFO阳性检出率均高于TTE,c-TEE检出的阳性患者最多。在Valsalva动作完成充分的情况下,c-TEE方法在显示PFO的结构形态、排查高危因素及RLS分级评定方面更具优势。Objective To compare the application value of TTE, C-TTE, TEE and C-TEE in the diagnosis of PFO.Methods Eighty-seven suspected patent foramen ovale and C-TCD positive patients in the 940 th Hospital of Joint Logistics Support Force of PLA from December 2020 to November 2021 were collected as research objects. All patients underwent TTE, C-TTE, TEE and C-TEE tests. The detection rates of PFO of different methods were compared and their advantages and disadvantages were analyzed.Results Among 87 patients, 71 cases of PFO were detected by C-TEE method, and the detection rate was 81.61%. the data for TEE, C-TTE and TTE were respectively 56 cases(64.37%). 47 patients(54.02%) and 23 patients(26.44%), and the difference between the four groups was statistically significant(P<0.05). The positive rate of C-TEE group was higher than that of C-TTE group(P<0.05), but there was no significant difference between the positive rate of C-TTE and TEE(P=0.165). After VM, the positive rate of C-TEE group was higher than that of C-TTE group(P<0.05).Conclusions The positive rates of C-TEE, C-TTE and TEE for PFO are higher than those of TTE, and most PFO positive patients are detected by C-TEE. Under the condition that VM is fully completed, C-TEE method can provide more valuable information and advantages in displaying the structure and shape of PFO, screening high-risk factors and grading and even evaluating RLS.

关 键 词：c-TEE 卵圆孔未闭 VALSALVA动作 右向左分流 

分 类 号：R445.1[医药卫生—影像医学与核医学] R741[医药卫生—诊断学]