目的 本研究探讨经食管超声心动图(transesophageal echocardiography,TEE)观察到的卵圆孔未闭(patent foramen ovale,PFO)的解剖结构与对比增强经胸超声心动图(contrast-enhanced transthoracic echocardiography,c-TTE)右向左分流(right to left shunt,RLS)分级的相关性.方法 回顾性分析南昌市第一医院 2021 年 11 月至 2022 年 12 月以TEE检查为诊断标准提示存在PFO的 90 例患者,根据患者c-TTE结果将RLS分为 4 个等级,分析PFO结构特征与RLS分级的相关性.结果 PFO内径大小与静息状态下RLS分级呈正相关(r=0.381,P<0.05);合并高活动性房间隔(hypermobile interatrial septum,HIS)患者的PFO内径更大,差异有统计学意义(P<0.05);合并持续性RLS的患者PFO内径较激发相患者更大,差异有统计学意义(P<0.05);合并长隧道患者的RLS分级与未合并长隧道患者的RLS分流程度差异无统计学意义;Valsalva动作下RLS分级与PFO内径大小无明显统计学差异.结论 研究表明PFO的某些解剖结构与RLS分级之间相互影响,且 PFO 解剖结构之间也可相互作用(合并有 HIS 的卵圆孔开放内径更大);同时 TEE 可清晰显示PFO的形态学特征,预测RLS的程度,从而进一步评估PFO患者发生缺血性脑卒中的可能性,同时为卵圆孔封堵手术的实施指征提供更多的依据.
Analysis of the correlation between the anatomical features of patent foramen ovale and right to left shunt
Objective To investigate the correlation between the anatomical structure of patent foramen ovale(PFO)observed by transesophageal echocardiography(TEE)and the right to left shunt(RLS)grade of contrast-enhanced transthoracic echocardiography(c-TTE).Methods Ninety cases in which the presence of PFO was suggested by TEE examination as a diagnostic criterion from November 2021 to December 2022 in the First Hospital of Nanchang were retrospectively analysed.According to the c-TTE results of patients,the RLS was divided into 4 levels,and the correlation between PFO structural characteristics and RLS grading was analyzed.Results There was a positive correlation between PFO diameter size and RLS grading in resting state(r=0.381,P<0.05);The PFO diameter of patients with hypermobile interatrial septum(HIS)was larger and the difference was statistically significant(P<0.05);The PFO diameter of patients with persistent RLS was larger than that of excited phase patients,and the difference was statistically significant(P<0.05);There was no significant difference in RLS shunt degree between patients with long tunnel and those without long tunnel;There was no significant difference in RLS grade and PFO diameter size under Valsalva state.Conclusion Research has shown that certain anatomical structures of PFO interact with RLS grading,and PFO anatomical structures can also interact with each other(the opening diameter of the foramen ovale with HIS is larger);At the same time,TEE can clearly show the morphological characteristics of PFO and predict the degree of RLS,so as to further evaluate the possibility of ischemic stroke in patients with PFO,and provide more evidence for the indications for foramen ovale closure.
Patent foramen ovaleAnatomical morphologyRight to left shuntTransesophageal echocardiographyContrast-enhanced transthoracic echocardiography
万方数据
维普
