经颅多普勒和经食道超声诊断卵圆孔未闭的对比观察  

Comparison of transcranial contrast Doppler and transesophageal contrast echocardiography in the detection of patent foramen ovale in migrainer

作　　者：周志彬[1] 于生元[1] 王广义[2] 王芳[1] 刘秀芳[1] 刘若卓[1] 

机构地区：[1]解放军总医院神经内科,北京100853 [2]解放军总医院心内科,北京100853

出　　处：《中国医药》2010年第5期388-390,共3页China Medicine

摘　　要：目的对门诊的偏头痛患者进行经颅多普勒超声（TCD）和经食道超声两项检查来诊断卵圆孔未闭，评估两者的优劣。方法经受试者同意后，选取我院神经内科门诊就诊的偏头痛患者41例，无先兆偏头痛15例，有先兆偏头痛26例，自肘前静脉注射手振生理盐水作为造影剂，并结合Valsava动作，进行经颅多普勒超声和经食道超声检测，诊断卵圆孔未闭。结果22例经颅多普勒超声和经食道超声检查两项均为阴性。16例两者均阳性，1例显示经食道超声阳性而经颅多普勒超声未发现微栓子信号。2例经颅多普勒超声阳性而经食道超声未发现卵圆孔未闭。结论经颅多普勒超声对卵圆孔未闭的检测具有高敏感性、高特异性，可作为怀疑卵圆孔未闭患者的筛查手段。Objective Transesophageal eehocardiography（TEE） and transcranial Doppler（TCD） examination with contrast injection can both be used to search for a patent foramen ovale（PFO）. We compared the accuracy of these techniques for identifying a PFO in patients with migraine. Methods PFO was assessed by performing TEE and TCD with IV injection of agitated saline in 41 subjects with migraine with aura （n =26） and without aura （n = 15） in Oct-patient department（OPD）. Results We found 22 PFOs with both TCD and TEE. Both contrast tests were negative in 16 patients. For 1 patient, the contrast test was positive only with TEE. And 2 were positive only in TCD. In comparison with TEE, adopted as the ＂gold standard＂, TCD had a sensitivity of 94% （16 of 17）, specificity of 92% （17 of 18）. Conclusions cTCD is an examination with high sensitivity and high specificity in detecting a PFO.

关 键 词：经颅多普勒 经食道超声心动图 卵圆孔未闭 有先兆偏头痛 无先兆偏头痛 

分 类 号：R445.1[医药卫生—影像医学与核医学]