不同激发方式在右心声学造影诊断卵圆孔未闭中的价值比较  

Comparison of the Application Value of Different Excitation Methods in the Diagnosis of Patent Foramen Ovale by Contrast Transthoracic Echocardiography

作　　者：黄静 刘健 Huang Jing;Liu Jian(Department of Ultrasound Medicine,West China Hospital-Yibin Hospital,Yibin 644000,China;Department of Ultrasound Medicine,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]宜宾市第二人民医院超声医学科,宜宾644000 [2]成都医学院第一附属医院超声医学科,成都610500

出　　处：《成都医学院学报》2024年第3期456-459,共4页Journal of Chengdu Medical College

基　　金：四川省卫生健康委员会重点研究科研项目(No:19ZD004);成都医学院第一附属医院专项研究科研项目(No:CYFY2021YB06)。

摘　　要：目的 比较不同激发方式在右心声学造影诊断卵圆孔未闭(PFO)右向左分流(RLS)中的应用价值。方法 选取2021年6月至2022年7月在宜宾市第二人民医院就诊的247例疑似PFO患者为研究对象,分别在静息状态(RS)、传统Valsalva动作(CM)、改良Valsalva动作(BM)及咳嗽动作(COF)状态下完成右心声学造影(cTTE)检查,并完善经胸超声心动图(TTE)和经食管超声心动图(TEE)检查。结果 BM对中-大量PFO-RLS检出率高于CM和COF(P<0.05);COF-BM对中-大量PFO-RLS检出率高于其他联合方式(P<0.05);COF-CM-BM和RS-COF-BM对中-大量PFO-RLS的检出率比较,差异无统计学意义(P>0.05);以TEE为诊断PFO的金标准,cTTE的灵敏度和AUC值高于TTE,分别为92.1%和81.5%,RS-COF-BM的灵敏度最高,AUC值较高。结论 cTTE适用于PFO的筛查,单独激发方式宜选用BM,激发方式联合使用宜选用COF-BM。Objective To compare the application value of different excitation methods in the diagnosis of patent foramen ovale(PFO)related right to left shunt(RLS)by contrast transthoracic echocardiography(cTTE).Methods A total of 247 patients with suspected PFO in the Second People's Hospital of Yibin from June 2021 to July 2022 were selected as the study subjects.All patients underwent the cTTE examination in different states,including resting state(RS),conventional Valsalva maneuver(CM),modified Valsalva maneuver(BM)and cough(COF).Transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE)examinations were also performed.Results The detection rate of moderate to medium large PFO-RLS in BM was higher than that in CM and COF(P<0.05).The detection rate of moderate to medium large PFO-RLS in COF-BM was higher than that in other combined methods(P<0.05).There was no significant difference in the detection rate of moderate to medium large PFO-RLS between COF-CM-BM and RS-COF-BM(P<0.05).Taking TEE as the gold standard for the diagnosis of PFO,cTTE had higher sensitivity and AUC value than TTE(92.1%and 81.5%,respectively),and RS-COF-BM had the highest sensitivity and higher AUC value for PFO-RLS.Conclusion cTTE can be used for screening patients with PFO.BM is preferred as the single excitation method in the process of cTTE.COF-BM is preferred as the combination of excitation methods in the process of cTTE.

关 键 词：卵圆孔未闭 右向左分流 经胸超声心动图 右心声学造影 经食管超声心动图 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]