右心声学造影结合经食管超声心动图在房间隔卵圆孔未闭中的应用  

Application of Right Heart Contrast Echocardiography Combined with Transesophageal Echocardiography in Patent Foramen Ovale

作　　者：庚靖淞 朱鲜阳 王琦光 盛晓棠 王思晨 肖家旺 GENG Jingsong;ZHU Xianyang;WANG Qiguang;SHENG Xiaotang;WANG Sichen;XIAO Jiawang(Department of Congenital Heart Disease,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院先心病内科,辽宁沈阳110016

出　　处：《中国医学影像学杂志》2020年第12期938-941,共4页Chinese Journal of Medical Imaging

基　　金：辽宁省科学技术计划项目(2019-ZD-1065)。

摘　　要：目的探讨右心声学造影(cTTE)结合经食管超声心动图(TEE)在房间隔卵圆孔未闭(PFO)中的应用。资料与方法纳入因偏头痛或不明原因脑卒中合并PFO患者88例,行cTTE检查,检查阳性者进一步行TEE检查,明确PFO的直径、隧道长度及原发隔活动度。结果TEE检测阳性85例,阴性3例。cTTE与TEE对PFO的诊断敏感度差异无统计学意义[100%(88/88)比96.59%(85/88),P=0.081]。cTTE显示右向左分流Ⅰ级6例,Ⅱ级20例,Ⅲ级62例。TEE所测PFO的大小、长度、原发隔活动度与cTTE检测的分流等级呈正相关(r=0.570、0.229、0.508,P均<0.05)。结论cTTE联合TEE可明确PFO解剖形态与分流等级的关系,判断因PFO形态引起偏头痛或不明原因脑卒中发生的影像学因素,为临床介入治疗提供理论依据。Purpose To explore the application of contrast transthoracic echocardiography(cTTE)combined with transesophageal echocardiography(TEE)in patent foramen ovale(PFO).Materials and Methods Eighty-eight patients with migraine or cryptogenic strokes with PFO were enrolled in this study.All patients were tested with cTTE,those with positive results took further examination of TEE,PFO diameter,tunnel length and primaryseptal activity were obtained.Results Eighty-five patients showed positive results by TEE,and 3 cases showed negative results.No statistical difference in the diagnostic sensitivity of PFO was observed between cTTE and TEE[100%(88/88)vs.96.59%(85/88),P=0.081].cTTE results showed that 6 cases were grade Ⅰ right-to-left shunt,20 cases were grade Ⅱ and 62 cases were grade Ⅲ.The size,length and activity of the primary septum measured by TEE were positively correlated with the shunt grade detected by cTTE(r=0.570,0.229 and 0.508,P<0.05).Conclusion cTTE combined with TEE can clarify the relationship between PFO anatomy and shunt grade,and determine the imaging factors of migraine or cryptogenic stroke by PFO,which provides a reliable theoretical basis for clinical treatment.

关 键 词：超声心动描记术 超声心动描记术 经食管 造影剂 卵圆孔 未闭 

分 类 号：R541.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]