Diagnostic value of contrast-enhanced ultrasonography for patent foramen ovale detection

被引:0
作者
Xu, Kun [1 ]
Tian, Xiaoguang [2 ]
Hao, Meifang
Li, Yiying [1 ]
Zhang, Jingxuan [1 ]
Wong, Randolph H. L. [3 ]
Othmani, Adrianna [4 ]
Zhang, Quanbin [5 ]
机构
[1] Shanxi Med Univ, Hosp 1, Taiyuan, Peoples R China
[2] Shanxi Med Univ, Hosp 5, Taiyuan, Peoples R China
[3] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Surg, Div Cardiothorac Surg, Hong Kong, Peoples R China
[4] Jagiellonian Univ Cracow, John Paul II Hosp, Inst Cardiol, Coll Med,Clin Dept Cardiac & Vasc Dis,Intens Cardi, Krakow, Poland
[5] Shanxi Med Univ, Hosp 6, 7 Yingxin Rd, Taiyuan 030012, Peoples R China
关键词
Ultrasonography; patent foramen ovale (PFO); diagnosis; semi-quantitative classification ability; right- to-left shunt (RLS); TO-LEFT SHUNT; TRANSCRANIAL DOPPLER; TRANSTHORACIC ECHOCARDIOGRAPHY; RECURRENT STROKE; DEVICE CLOSURE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; ACCURACY;
D O I
10.21037/jtd-24-330
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Patent foramen ovale (PFO) has been associated with migraine, cryptogenic stroke (CS), and hypoxemia. However, which examination method is most reliable remains controversial. This study sought to investigate the diagnostic value of contrast-enhanced ultrasonography (cU), including contrast-enhanced transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE), for PFO; and to determine the best diagnostic strategy. Methods: This retrospective observational study included a total of 147 consecutive patients suspected PFO at The First Hospital of Shanxi Medical University between October 2019 and January 2022. The patients also underwent cTCD, cTTE, and cTEE examinations. The standard for the diagnosis of PFO was confirmation of the presence of PFO by color Doppler flow signals or contrast microbubbles (MBs) passing through the foramen ovale. Results: A total of 123 patients were diagnosed with PFO and 24 patients without PFO during the study period. The detectable rates of cTCD, cTTE, and cTEE were 120 (97.56%), 110 (89.43%), and 121 (98.37%), respectively. The sensitivity between cTCD and cTEE for PFO were comparable [97.56%, 95% confidence interval (CI): 92.5% to 99.4% vs. 98.37%, 95% CI: 93.7% to 99.7%; P>0.99], and the sensitivity of both were higher than that of cTTE (89.43%, 95% CI: 82.3% to 94.0%; P=0.02 and P=0.001, respectively). In addition, the specificity of cTEE for PFO was significantly higher than that of cTCD (100%, 95% CI: 82.3% to 100.0% vs. 75.00%, 95% CI: 53.0% to 89.4%; P<0.001) and cTTE (100%, 95% CI: 82.3% to 100.0% vs. 75.00%, 95% CI: 53.0% to 89.4%; P<0.001). Further, the semi-quantitative classification ability of cTCD for PFO with right-to-left shunt (RLS) was significantly higher than that of cTTE and cTEE (P=0.02 and P<0.001, respectively), and that of cTTE was significantly higher than that of cTEE (P=0.01). The Spearman analysis showed that the degree of RLS was positively correlated with the inner diameter of the PFO (r=0.695, P<0.001). Conclusions: The combination of cTCD and cTEE may provide a favorable strategy for the diagnosis of PFO.
引用
收藏
页码:3282 / 3290
页数:10
相关论文
共 37 条
[21]   Accuracy of Transcranial Doppler for the Diagnosis of Intracardiac Right-to-Left Shunt A Bivariate Meta-Analysis of Prospective Studies [J].
Mojadidi, M. Khalid ;
Roberts, Scott C. ;
Winoker, Jared S. ;
Romero, Jorge ;
Goodman-Meza, David ;
Gevorgyan, Rubine ;
Tobis, Jonathan M. .
JACC-CARDIOVASCULAR IMAGING, 2014, 7 (03) :236-250
[22]   Diagnostic Accuracy of Transesophageal Echocardiogram for the Detection of Patent Foramen Ovale: A Meta-Analysis [J].
Mojadidi, Mohammad Khalid ;
Bogush, Nikolay ;
Caceres, Jose Diego ;
Msaouel, Pavlos ;
Tobis, Jonathan M. .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2014, 31 (06) :752-758
[23]   European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism [J].
Pristipino, Christian ;
Sievert, Horst ;
D'Ascenzo, Fabrizio ;
Mas, Jean Louis ;
Meier, Bernhard ;
Scacciatella, Paolo ;
Hildick-Smith, David ;
Gaita, Fiorenzo ;
Toni, Danilo ;
Kyrle, Paul ;
Thomson, John ;
Derumeaux, Genevieve ;
Onorato, Eustaquio ;
Sibbing, Dirk ;
Germonpre, Peter ;
Berti, Sergio ;
Chessa, Massimo ;
Bedogni, Francesco ;
Dudek, Dariusz ;
Hornung, Marius ;
Zamorano, Jose ;
D'Ascenzo, Fabrizio ;
Omede, Pierluigi ;
Ballocca, Flavia ;
Barbero, Umberto ;
Giordana, Francesca ;
Gili, Sebastiano ;
Iannaccone, Mario ;
Capodannno, Davide ;
Valgimigli, Marco ;
Byrne, Robert ;
Akagi, Teiji ;
Carroll, John ;
Dalvi, Bharat ;
Ge, Junbo ;
Kasner, Scott ;
Michel-Behnke, Ina ;
Pedra, Carlos ;
Rhodes, John ;
Sondergaard, Lars ;
Thomassen, Lars ;
Biondi-Zoccai, Giuseppe G. L. .
EUROINTERVENTION, 2019, 14 (13) :1389-1402
[24]   PFO and Migraine: Is There a Role for Closure? [J].
Rayhill, Melissa ;
Burch, Rebecca .
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS, 2017, 17 (03)
[25]   Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke [J].
Saver, Jeffrey L. ;
Carroll, John D. ;
Thaler, David E. ;
Smalling, Richard W. ;
MacDonald, Lee A. ;
Marks, David S. ;
Tirschwell, David L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (11) :1022-1032
[26]   Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions [J].
Silvestry, Frank E. ;
Cohen, Meryl S. ;
Armsby, Laurie B. ;
Burkule, Nitin J. ;
Fleishman, Craig E. ;
Hijazi, Ziyad M. ;
Lang, Roberto M. ;
Rome, Jonathan J. ;
Wang, Yan .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2015, 28 (08) :910-958
[27]   Patent Foramen Ovale: A Comprehensive Review [J].
Teshome, Meron K. ;
Najib, Khalid ;
Nwagbara, Chioma C. ;
Akinseye, Oluwaseun A. ;
Ibebuogu, Uzoma N. .
CURRENT PROBLEMS IN CARDIOLOGY, 2020, 45 (02) :1-14
[28]   Recurrent stroke predictors differ in medically treated patients with pathogenic vs other PFOs [J].
Thaler, David E. ;
Ruthazer, Robin ;
Weimar, Christian ;
Mas, Jean-Louis ;
Serena, Joaquin ;
Di Angelantonio, Emanuele ;
Papetti, Federica ;
Homma, Shunichi ;
Mattle, Heinrich P. ;
Nedeltchev, Krassen ;
Mono, Marie-Luise ;
Jaigobin, Cheryl ;
Michel, Patrik ;
Elkind, Mitchell S. V. ;
Di Tullio, Marco R. ;
Lutz, Jennifer S. ;
Griffith, John ;
Kent, David M. .
NEUROLOGY, 2014, 83 (03) :221-226
[29]   PFO Device Closure Despite Thrombophilia The Need for Good Observational Studies [J].
Tobis, Jonathan M. .
JACC-CARDIOVASCULAR INTERVENTIONS, 2023, 16 (11) :1367-1368
[30]   Atrial Septal Aneurysm, Shunt Size, and Recurrent Stroke Risk in Patients With Patent Foramen Ovale [J].
Turc, Guillaume ;
Lee, Jong-Young ;
Brochet, Eric ;
Kim, Jong S. ;
Song, Jae-Kwan ;
Mas, Jean-Louis .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 75 (18) :2312-2320