不同检查方法对PFO的诊断价值探讨  

Comparative Analysis of Different Methods in Diagnosis of PFO

作　　者：王寒梅[1] 邢丽敏[1] 赵德霞[1] 周振芳[1] 于丹[1] 王磊[1] 李冰然 Wang Hanmei;Xing Limin;Zhao Dexia;Zhou Zhenfang;Yu Dan;Wang Lei;Li Bingran(Department of Echocardiography,Daqing Oilfield General Hospital,Daqing,Heilongjiang 163001,China)

机构地区：[1]大庆油田总医院超声心动室,黑龙江省大庆市163001

出　　处：《中国超声医学杂志》2022年第9期961-964,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨经颅多普勒声学造影(cTCD)、经胸超声心动图声学造影(cTTE)及经食管超声心动图(TEE)对卵圆孔未闭(PFO)的诊断价值。方法 回顾性分析疑诊PFO相关疾病,行cTCD及cTTE联合检查的468例患者资料,比较cTCD及cTTE两种方法对右向左分流(RLS)检出率及分级水平的差异。其中152例行TEE检查。结果 cTCD和cTTE检出RLS阳性率分别为41.03%(192/468)和59.19%(277/468);cTCD检出RLS的分级水平低于cTTE,两者对Ⅱ~Ⅲ级RLS检出率分别为17.09%(80/468)和40.38%(189/468)。TEE检查中59.21%(90/152)明确诊断为PFO。结论 TEE对PFO的诊断能力低于cTTE或cTCD。高质量cTTE对RLS检出率及分级程度均高于cTCD。有效的诱发试验对检出RLS至关重要。Objective To compare the diagnostic value of cTCD, cTTE and TEE in detecting PFO. Methods The data of cTCD and cTTE examinations in 468 patients with suspected PFO related disease in Daqing Oilfield General Hospital were retrospectively analyzed. cTCD and cTTE were used to compare their diagnostic performance for RLS, as well as RLS classification. 152 of the cases also underwent TEE examination. Results The positive rate of RLS observed by cTCD and cTTE were 41.03%(192/468) and 59.19%(277/468), respectively, which was statistically significant(P<0.01). RLS level were lower in cTCD compared with cTTE, RLS level Ⅱ or Ⅲ in cTCD and cTTE were 17.09%(80/468) and 40.38%(189/468), respectively. PFO was definitely diagnosed in 59.21%(90/152) of TEE examination. Conclusions TEE has lower diagnostic efficiency in detecting PFO compared with cTTE or cTCD. High quality cTTE showed a higher diagnostic efficiency in detecting RLS than cTCD. Sufficient Valsalva manoeuvre is critical in the detection of RLS.

关 键 词：经颅多普勒声学造影 经胸超声心动图声学造影 经食管超声心动图 右向左分流 卵圆孔未闭 

分 类 号：R540.45[医药卫生—心血管疾病] R541[医药卫生—内科学]