Diagnostic value of contrast-transthoracic echocardiography plus contrast-enhanced transcranial Doppler for patent foramen ovale-right to left shunt
Objective To investigate the diagnostic value of contrast transthoracic echocardiography(c-TTE)plus con-trast-enhanced transcranial Doppler(c-TCD)for patent foramen ovale right to left shunt(PFO-RLS).Methods The data of 218 PFO patients were examined with transesophageal echocardiography(TEE),and c-TTE plus C-TCD in the resting state and Valsalva state,to assess its diagnostic value for PFO-RLS.Results The detection rate of PFO-RLS was significantly higher in Valsalva state than in resting state(P<0.05).In both state,the c-TTE plus c-TCD examina-tion showed a higher detection rate than c-TTE(P<0.05)or c-TCD alone(P<0.05).When patients had grade I dis-ease,c-TCD had a higher detection rate than c-TTE(P<0.05),but there was no significant difference in the detection rate when the disease was Grade Ⅱ or Grade Ⅲ(P>0.05).In grade Ⅰ and Ⅱ cases,c-TTE plus c-TCD showed a higher detection rate than c-TTE(P<0.05)or c-TCD alone(P<0.05),but there was no significant difference in the detection rate between c-TTE or c-TCD alone,or combined examination in grade Ⅲ cases(P>0.05).Conclusion The Valsalva maneuver which increases the right atrial pressure can significantly improve the detection rate of PFO-RLS.The sensitiv-ity and accuracy of c-TTE plus C-TCD are significantly improved in the diagnosis of PFO-RLS compared with those of c-TTE and C-TCD alone(P<0.05).
Contrast-transthoracic echocardiographyContrast-enhanced transcranial DopplerPatent foramen ovaleRight to left shuntCombined examination
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