经食道三维超声心动图在隐源性脑卒中患者中检测卵圆孔未闭的应用价值  

The application value of three-dimensional transesophageal echocardiography in the detection of patent foramen ovale in patients with cryptogenic stroke

作　　者：崔美红 邓华钊[1] 李珺 Cui Meihong;Deng Huazhao;Li Jun(Cardiology Department,the Third Hospital of Huizhou City,Huizhou 516002,China)

机构地区：[1]广东省惠州市第三人民医院心脏检测科,516002

出　　处：《心脑血管病防治》2021年第4期350-352,374,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：广东省惠州市科技计划项目(2019Y186)。

摘　　要：目的探讨经食道三维超声心动图(3D-TEE)在隐源性脑卒中(CS)患者中检测卵圆孔未闭(PFO)的应用价值。方法入选2019年4月至2020年4月惠州市第三人民医院收治的CS患者60例,分别用经胸常规超声心动图(TTE)、经食道二维超声心动图(2D-TEE)和3D-TEE三种方法进行检测,比较PFO的检出率及相关测量数据。结果60例CS患者中,TTE检出17例合并有PFO(28.3%),2D-TEE和3D-TEE均检出39例合并有PFO(65%),其中有9例合并有ASA。3D-TEE及2D-TEE较TTE对PFO的检出率均明显提高(χ^(2)=11.562、11.562,P<0.05)。另在检查过程中发现,TTE虽然可以发现PFO的存在,但无法精确测得PFO的相关参数,而3D-TEE对PFO相关参数的测量比2D-TEE更精确,检测数据显示3D-TEE测量PFO的右房侧入口宽度、中间宽度以及左房侧出口宽度均大于2D-TEE的测值,差异有统计学意义(t=7.738、6.876、8.480,P<0.05);2D-TEE和3D-TEE测得的PFO入口最大宽度均大于出口最大宽度,差异有统计学意义(t=7.863、8.126,P<0.05)。结论3D-TEE不但可以明显提高PFO的检出率,而且可以获得更精确、更直观的PFO三维图像,从而为临床诊断和治疗提供更精准的影像学依据。Objective To investigate the value of three-dimensional transesophageal echocardiography(3D-TEE)in detecting patent foramen ovale(PFO)in patients with cryptogenic stroke(CS).Methods From April 2019 to April 2020,60 patients with cryptogenic stroke admitted to the Third Hospital of Huizhou City were selected and detected by routine transthoracic echocardiography(TTE),two-dimensional transesophageal echocardiography(2D-TEE)and three-dimensional transesophageal echocardiography(3D-TEE)respectively,and the detection rate of PFO and related measurement data were compared.Results Of the 60 CS patients,17 cases with PFO(28.3%)were detected by TTE,39 cases with PFO(65%)were detected by both 2D-TEE and 3D-TEE,and of the 39 cases there were 9 cases with ASA.The detection rates of 3D-TEE and 2D-TEE were significantly higher than that of TTE(χ^(2)=11.562,11.562;P<0.05).In addition,during the inspection,it was found that although TTE could detect the existence of PFO,it could not accurately measure the relevant parameters of PFO,while 3D-TEE was more accurate than 2D-TEE in measuring the relevant parameters of PFO.The detection data showed that the right side exit width,the middle width and left side outlet width of PFO measured by 3D-TEE were all greater than those data measured by 2D-TEE,and the differences were statistically significant(t=7.738,6.876,8.480;P<0.05).The maximum inlet width of PFO was greater than the maximum exit width whether measured by 2D-TEE or by 3D-TEE,and the difference was statistically significant(t=7.863,8.126;P<0.05).Conclusion 3D-TEE can not only significantly improve the detection rate of PFO,but also obtain more accurate and intuitive three-dimensional image of PFO,so as to provide a more accurate imaging basis for clinical diagnosis and treatment.

关 键 词：经食道超声心动图 三维 隐源性脑卒中 卵圆孔未闭 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.1[医药卫生—临床医学]