Objective To study the accuracy and feasibility of contrast transthoracic-echocardiography in the differential diagnosis of patent foramen ovale(PFO)and pulmonary arteriovenous shunt.Methods This study included 96 patients with unexplained headache and younger cerebral infarction diagnosed and treated in Traditional Chinese Medicine Hospital of Taian from February 2022 to July 2023.Through contrast transthoracic-echocardiography(cTTE)and transesophageal echocardiography(TEE)examination,observeing the right to left shunt flow rate,the cardiac cycle and duration of shunt occurrence under resting and Valsalva manoeuvre,and interpreting the diagnosis based on expert consensus that atrial level shunt and pulmonary arteriovenous shunt were determined.The cTTE diagnostic PFO group and TEE results,the results of cTTE in diagnosing right to left pulmonary arteriovenous shunt with those of pulmonary angiography,were compared to determine the diagnostic effect of cTTE on patent foramen ovale and right to left pulmonary arteriovenous shunt.Results Among 96 patients,56 were diagnosed with right to left shunt of PFO through cTTE,and 54 were diagnosed with PFO through TEE,with a diagnostic accuracy rate of 96.4%;The diagnosis of pulmonary arteriovenous shunts included 8 cases of suspected physiological shunts,including 5 cases of pulmonary arteriovenous physiological shunts,1 case of pulmonary arteriovenous fistula,and 2 cases of PFO with physiological shunts.After pulmonary angiography examination,there were 6 cases of pulmonary arteriovenous shunts,with a diagnostic accuracy rate of 75.0%.Among them,1 case of pulmonary arteriovenous fistula(PAVF),4 cases of pulmonary arteriovenous physiological shunts,and 1 case of PFO with physiological shunts.Conclusion cTTE can relatively accurately distinguish between PFO and pulmonary arteriovenous right to left shunt,and has certain application value in distinguishing PFO from pulmonary arteriovenous shunt.This is of great significance for clinical doctors to choose appropriate treatment plans and develop personalized treatment plans.
维普
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