Comparison of Transthoracic Echocardiography and Transthoracic Right Heart Contrast Echocardiography in the Diagnosis of Migraine and Right-to-Left Shunt Caused by Patent Foramen Ovale
Objective:To investigate the value of transthoracic echocardiography(TTE)and transthoracic right heart contrast echocardiography(c-TTE)in the diagnosis of migraine and right-to-left shunt(RLS)caused by patent foramen ovale(PFO).Methods:82 patients with suspected PFO-induced migraine were selected,all patients underwent TTE and c-TTE examinations,the result of digital subtraction angiography(DS A)was used as the gold standard,the consistency of TTE,c-TTE and DS A results was tested by Kappa coef-ficient,the efficacy of TTE and c-TTE in the diagnosis of PFO-induced migraine and RLS was analyzed by four-grid table method and receiver operating characteristic(ROC)curve.Results:Among the 82 migraine patients,60 cases of PFO were diagnosed by DS A.TTE detected a total of 42 cases of PFO,which was generally consistent with the diagnostic results of DSA(Kappa=0.294,P＜0.05).c-TTE detected a total of 57 cases of PFO,which was highly consistent with the results of DSA(Kappa=0.879,P＜0.05).TTE detected a total of 36 cases of RLS,which was generally consistent with the diagnostic results of DSA(Kappa=0.260,P＜0.05).c-TTE detected a total of 53 cases of RLS,which was consistent with the results of DSA(Kappa=0.706,P＜0.05).Compared with TTE,c-TTE diagnosed PFO with higher sensitivity,specificity,accuracy,positive predictive value and negative predictive value(Z=4.889,P＜0.05).Compared with TTE,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of c-TTE in diagnosing RLS were higher(Z=4.412,P＜0.05).Conclusion:Relative to TTE,c-TTE can diagnose PFO and RLS classification more sensitively and accurately,and has higher diagnostic value in patients with migraine due to PFO.
MigrainePatent foramen ovaleRight-to-left shuntTransthoracic echocardiographyTransthoracic right heart contrast echocardiographyDiagnostic efficiency
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