The Value of Contrast Transcranial Doppler in Diagnosing Ischemic Stroke with Patent Foramen Ovale
Objective To analyze the value of contrast transcranial doppler(cTCD)in diagnosing ischemic stroke(IS)with patent foramen ovale(PFO).Methods With the retrospective analysis of clinical data from 356 patients with IS who underwent cTCD,transesophageal echocardiography,and right heart contrast echocardiography in hospitals from June 2021 to December 2023,using the results of transesophageal echocardiography and right heart contrast echocardiography as the gold standard,the diagnostic value of cTCD for IS with PFO was analyzed.In addition,general information such as RLS grading and ischemic site were compared between PFO positive patients diagnosed with cTCD in resting state[Inherent right to left shunt(RLS)]and PFO positive patients with Valsalva action(Potential RLS).Results Among the 356 IS patients,82 patients were diagnosed with PFO by the gold standard,and 85 patients were diagnosed with PFO by cTCD(42 patients with inherent RLS and 43 patients with potential RLS).The diagnostic sensitivity,specificity and accuracy of cTCD for IS combined with PFO were 90.24%,95.99%and 94.66%,and the Kappa coefficient of consistency with gold standard was 0.851(P<0.05).The RLS grade and the proportion of multiple ischemic foci in patients with inherent RLS were higher than those with potential RLS,and the proportion of posterior circulation ischemia was lower than those with potential RLS,with statistical significance(P<0.05).Conclusion The diagnostic value of cTCD for IS with PFO is high.Potential RLS patients have lower RLS grading,and the RLS types of IS patients with different ischemic foci and ischemic sites are different,which can provide reference for clinical treatment.
Contrast transcranial dopplerIschemic strokePatent foramen ovaleRight to left shunt
NETL
NSTL
万方数据
