右心声学造影联合c-TCD在卵圆孔未闭RLS分级中的临床意义
Clinical significance of right heart contrast echocardiography combined with c-TCD in RLS grad-ing of patent foramen ovale
赵洁 1禹海贺 2王辉3
作者信息
- 1. 郑州四六○医院(河南郑州 450000)
- 2. 联勤保障部队第九八八医院(河南郑州 450000)
- 3. 郑州市第五人民医院(河南郑州 450000)
- 折叠
摘要
目的 探讨右心声学造影(c-TTE)联合经颅多普勒发泡试验(c-TCD)在卵圆孔未闭右向左分流(RLS)分级中的临床意义.方法 回顾性选取2021年5月-2023年5月我院神经内科收治的疑似PFO-RLS患者105例,所选病例均进行c-TTE、c-TCD及经食管超声心动图(TEE)检查,以TEE检查为"金标准",将患者分为PFO-RLS组(73例)、非PFO-RLS组(32例).比较c-TTE结果、c-TCD结果及联合检查与TEE检查结果,比较不同检查方式诊断效能,分析不同检查方式与TEE检查RLS分级结果的一致性.结果 以TEE检查为"金标准",c-TTE诊断灵敏度为89.04％、特异度为96.88％、准确率为91.43％,c-TCD诊断灵敏度为86.30％、特异度为88.57％、准确率为88.57％,联合诊断灵敏度为98.63％、特异度为90.63％、准确率为96.19％;与c-TTE、c-TCD单独诊断相比,联合诊断灵敏度较高,漏诊率较低,且联合诊断RLS分级结果的一致性最佳(P＜0.05).结论 c-TTE、c-TCD联合应用可提高PFO-RLS诊断灵敏度,降低漏诊率,且对RLS分级的评估价值较高,值得临床推广应用.
Abstract
Objective To investigate the clinical significance of contrast echocardiography(c-TTE)combined with tran-scranial Doppler bubble test(c-TCD)in the classification of right-to-left shunt(RLS)in patients with patent foramen ovale(PFO).Methods A total of 105 patients with suspected PFO-RLS admitted to the Department of Neurology of our hospital from May 2021 to May 2023 were retrospectively selected.All the selected patients underwent c-TTE,c-TCD and transesophageal echocardiography(TEE),with TEE as the"gold standard".The patients were divided into PFO-RLS group(n=73)and non-PFO-RLS group(n=32).The results of c-TTE,c-TCD,combined examination and TEE examination were compared.The diagnostic efficacy of different examination methods was compared,and the consistency of RLS grading re-sults between different examination methods and TEE examination was analyzed.Results Taking TEE as the"gold stand-ard",the diagnostic sensitivity,specificity and accuracy of c-TTE were 89.04％,96.88％and 91.43％,and the diagnostic sensitivity,specificity and accuracy of c-TCD were 86.30％,88.57％and 88.57％.The sensitivity,specificity and accuracy of combined diagnosis were 98.63％,90.63％and 96.19％,respectively.Compared with c-TTE and c-TCD alone,the com-bined diagnosis had a higher sensitivity and a lower missed diagnosis rate,and the consistency of the combined diagnosis of RLS grading results was the best(P＜0.05).Conclusion The combination of c-TTE and c-TCD can improve the diagnos-tic sensitivity of PFO-RLS,reduce the rate of missed diagnosis,and has a high evaluation value for RLS classification,which is worthy of clinical application.
关键词
右心声学造影/经颅多普勒发泡试验/卵圆孔未闭/右向左分流Key words
Right heart contrast echocardiography/Transcranial Doppler foam test/Patent foramen ovale/Right to left shunt引用本文复制引用
出版年
2024
NETL
NSTL
万方数据