Contrast Enhanced Transcranial Doppler Sonography and Contrast Transthoracic Echocardiography in Diagnosing Patent Foramen Ovale:a Comparative Study
Objective To investigate the clinical value of contrast enhanced transcranial Doppler sonography(c-TCD)and contrast transthoracic echocardiography(c-TTE)in the diagno-sis of patent foramen ovale(PFO).Methods A total of 119 patients with suspected PFO admitted to Affiliated Wuhu Hospital of East China Normal University from January 2022 to September 2023 were selected for routine transthoracic echocardiography(TTE),and c-TCD and c-TTE were completed simultaneously.The diagnostic value of c-TCD and c-TTE for PFO was compared using contrast transesophageal echocardiography(c-TEE)as the gold standard for PFO diagnosis.Results There was no statistically significant difference in the detection rates of right-to-left shunt(RLS)between the resting state and the Valsalva maneuver with c-TCD and c-TTE(P＞0.05);compared with the resting state,the detection rates of RLS were significantly higher in the Valsalva maneuver with c-TCD and c-TTE(P＜0.05).In the resting state,the difference between c-TTE and c-TCD quantifying RLS shunt grades was statistically significant(P＜0.05),with c-TCD being more diagnostic for large numbers of shunts;the difference between c-TTE and c-TCD quantifying RLS shunt grades was not statistically significant in the Valsalva maneuver(P＞0.05).There was no statistically significant difference in the semiquantitative grading of RLS detected by c-TTE compared with c-TCD(P＞0.05).A total of 33 patients completed c-TEE,with c-TEE as the gold standard for diagnosing PFO.c-TTE had a sensitivity of 88.9％,specificity of 83.3％,and Jordon's index of 0.72 for diagnosing PFO,while c-TCD had a sensitivity of 96.3％,specificity of 66.7％,and Jordon's index of 0.63.The combined diagnosis of PFO by c-TCD and c-TTE had a sensitivity of 100.0％.Conclusion Both c-TTE and c-TCD had increased detection of PFO in the Valsalva maneuver,and c-TCD was more advantageous in quantifying the shunt grade of RLS in the resting state.The sensitivity of c-TCD in diagnosing PFO was higher than c-TTE,the specificity was lower than c-TTE,and the combination of the two might be more advanta-geous than either method in diagnosing PFO
contrast enhanced transcranial Doppler sonographycontrast transthoracic echocardiographypatent foramen ovalediagnostic value
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