目的 比较经胸超声心动图、经胸超声心动图联合右心声学造影、经食管超声心动图、经食管超声心动图联合右心声学造影四种检查方法对卵圆孔未闭(PFO)诊断的应用价值。方法 收集联勤保障部队第940医院2020-12至2021-11临床疑似PFO和经颅多普勒超声声学造影阳性患者87例为研究对象,所有患者同时行经胸超声心动图(TTE)、经胸超声心动图联合右心声学造影(c-TTE)、经食管超声心动图(TEE)和经食管超声心动图联合右心声学造影(c-TEE)检查,比较不同方法的PFO检出率,分析各自优缺点。结果 87例中,c-TEE检出PFO 71例(检出率81.61%),TEE检出PFO 56例(检出率64.37%),c-TTE检出PFO 47例(检出率54.02%),TTE检出PFO 23例(检出率为26.44%),四组之间差异有统计学意义(P＜0.05)。c-TEE组阳性检出率高于c-TTE组(P＜0.05),而c-TTE与TEE两组间阳性检出率差异无统计学意义(P=0.165)。Valsalva动作后,c-TEE组阳性检出率高于c-TTE组(P＜0.05)。结论 四种方法比较,c-TEE、c-TTE、TEE对PFO阳性检出率均高于TTE,c-TEE检出的阳性患者最多。在Valsalva动作完成充分的情况下,c-TEE方法在显示PFO的结构形态、排查高危因素及RLS分级评定方面更具优势。
Abstract
Objective To compare the application value of TTE, C-TTE, TEE and C-TEE in the diagnosis of PFO. Methods Eighty-seven suspected patent foramen ovale and C-TCD positive patients in the 940th Hospital of Joint Logistics Support Force of PLA from December 2020 to November 2021 were collected as research objects. All patients underwent TTE, C-TTE, TEE and C-TEE tests. The detection rates of PFO of different methods were compared and their advantages and disadvantages were analyzed. Results Among 87 patients, 71 cases of PFO were detected by C-TEE method, and the detection rate was 81.61%. the data for TEE, C-TTE and TTE were respectively 56 cases(64.37%). 47 patients(54.02%) and 23 patients(26.44%), and the difference between the four groups was statistically significant (P<0.05). The positive rate of C-TEE group was higher than that of C-TTE group (P<0.05), but there was no significant difference between the positive rate of C-TTE and TEE (P=0.165). After VM, the positive rate of C-TEE group was higher than that of C-TTE group (P<0.05). Conclusions The positive rates of C-TEE, C-TTE and TEE for PFO are higher than those of TTE, and most PFO positive patients are detected by C-TEE. Under the condition that VM is fully completed, C-TEE method can provide more valuable information and advantages in displaying the structure and shape of PFO, screening high-risk factors and grading and even evaluating RLS.
关键词
c-TEE /
卵圆孔未闭 /
Valsalva动作 /
右向左分流
Key words
contrast transesophageal echocardiography /
patent foramen ovale /
valsalva maneuver /
right-to-left shunt /
positive detection rate
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