经食管及经胸心脏超声联合右心造影提高成人卵圆孔未闭检出率
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摘要
目的:比较经食管心脏超声(Transesophageal echocardiography TEE)与经胸心脏超声(transthoracic echocardiography TTE)及右心造影对成人卵圆孔未闭(Patent foramen ovale PFO)的检出率以及联合检查的检出率。方法:应用经食道以及经胸心脏探头,对288例经临床诊断不明原因偏头痛及脑梗塞患者进行经超声检查。分别进行TEE、TTE、右心造影各项检查以及联合方式检查,比较它们的检出率与联合检查的检出率以及与脑卒中(Cryptogenic stroke,CS)的相关性。。结果:TEE单独检出率是33. 3%～37. 5%,右心造影检出率是18. 0%～41. 6%,TEE与TTE右心造影两者联合的检出率44. 4%。结论:TEE检查与TTE右心造影检查联合检出率显著高出各单项检出率,合理运用复合联检,有益于提高PFO的检出率,对于PFO相关的疾病的诊断与治疗大有裨益。
Objective: To compare the detection rate of Patent foramen ovale in adults by transesophageal echocardiography(TEE),transthoracic echocardiography(TTE) and right cardiography,and the detection rate of combined examination. Methods: 288 patients with clinically diagnosed unexplained migraine and cerebral infarction were examined by GE-Vivid E8 color Doppler flow imaging system with transthoracic and transesophageal probes ranging from 3. 7 MHz to 5. 0 MHz. TEE,TTE,right ventriculography and combined examination were performed to compare their detection rate with that of combined examination. According to the detection rate of combined detection,the correlation between stroke and detection rate was determined by statistics. Results: The detection rate of TEE alone was 33. 3% ～ 37. 5%. The detection rate of right heart angiography was 18. 0% ～ 41. 6%. The detection rate of TEE combined with TTE right heart angiography was 44. 4%. Conclusions: The combined detection rate of TEE and TTE right ventriculography is obviously higher than that of each single item. Rational use of combined detection is beneficial to improve the detection rate of patent foramen ovale in adults and to the diagnosis and treatment of diseases related to patent foramen ovale.
Objective: To compare the detection rate of Patent foramen ovale in adults by transesophageal echocardiography(TEE),transthoracic echocardiography(TTE) and right cardiography,and the detection rate of combined examination. Methods: 288 patients with clinically diagnosed unexplained migraine and cerebral infarction were examined by GE-Vivid E8 color Doppler flow imaging system with transthoracic and transesophageal probes ranging from 3. 7 MHz to 5. 0 MHz. TEE,TTE,right ventriculography and combined examination were performed to compare their detection rate with that of combined examination. According to the detection rate of combined detection,the correlation between stroke and detection rate was determined by statistics. Results: The detection rate of TEE alone was 33. 3% ～ 37. 5%. The detection rate of right heart angiography was 18. 0% ～ 41. 6%. The detection rate of TEE combined with TTE right heart angiography was 44. 4%. Conclusions: The combined detection rate of TEE and TTE right ventriculography is obviously higher than that of each single item. Rational use of combined detection is beneficial to improve the detection rate of patent foramen ovale in adults and to the diagnosis and treatment of diseases related to patent foramen ovale.
引文
[1]王卫平,毛萌.儿科学[M].第8版.北京:人民卫生出版社,2015:288.
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[5]Rigatelli G,Dell'Avvocata F,Cardaioli P,et al.Permanent right-to-left shunt is the key factor in managing patent foramen ovale[J].J Am Coll Cardiol,2017,58:2257-2261.
[6]Schneider B,ofmann T,Justen MH,et al.Chiari's network:normal anatomic variant or risk factor for arterial embolic events[J].J Am Coll Cardiol,2013,26:203-210.
[2]Brogno D Lancaster G,Rosenbaum M.Embolus Interuptus[J].N Engl J Med,1994,330:1761-1762.
[3]张玉顺,朱鲜阳.卵圆孔未闭处理策略中国专家建议[J].心脏杂志,2015,4:373-379.
[4]Mattle HP,Meier B,Nedeltchev k,et al.Prevention of stroke in patients with patent foramen ovale[J].Int JStroke,2016,5:92-102.
[5]Rigatelli G,Dell'Avvocata F,Cardaioli P,et al.Permanent right-to-left shunt is the key factor in managing patent foramen ovale[J].J Am Coll Cardiol,2017,58:2257-2261.
[6]Schneider B,ofmann T,Justen MH,et al.Chiari's network:normal anatomic variant or risk factor for arterial embolic events[J].J Am Coll Cardiol,2013,26:203-210.