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右心声学造影在卵圆孔未闭检测中的应用价值

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摘要:

目的 探讨超声右心声学造影(cTTE)在卵圆孔未闭(PFO)检测中的应用价值。方法
回顾性分析2017年1月至2020年9月于山西省心血管病医院因怀疑PFO行cTTE的患者354例,均在cTTE
前常规行经胸超声心动图(TTE),其中147例行经食管超声心动图(TEE)。结果 TTE的PFO检出率
为60.5%(89/147)低于TEE的70.7%(104/147),差异具有统计学意义(P<0.05);TEE低于cTTE的
76.8%(113/147),差异无统计学差异(P>0.05)。cTTE检测存在心内右向左分流的16例患者中,TEE
显示房间隔未见明显异常,3例经皮介入封堵手术后,行cTTE检测右向左分流分级下降至1级及阴性,证
实为PFO相关的右向左分流。经皮介入封堵PFO术后1周Valsalva动作后右向左分流检出率为46.3%。结论
CTTE检测右向左分流具有独特价值,是TTE和TEE检测PFO中的有益补充。

Abstract:

Objective To discuss the application value of contrast-transthoracic echocardiography (cTTE)
in detection of patent foramen ovale (PFO). Methods The patients with suspected PFO undergone cTTE (n=354)
were retrospectively analyzed in Hospital of Cardiovascular Medicine of Shanxi Province from Jan. 2017 to Sept.
2020. All patients were given examination of routine TTE before cTTE and 147 patients were given examination
of transesophageal echocardiography (TEE). Results The detection rate of PFO by TTE was 60.5% (89/147) and
that by TEE was 70.7% (104/147, P<0.05). The detection rate of PFO by cTTE was 76.8% (113/147) and had no
difference compared with TEE (P>0.05). In 16 patients with cTTE for detecting intracadiac right-to-left shunt, TEE
did not show significant atrial septal abnormality. After percutaneous closure in 3 patients, the grades of right-toleft
shunt detected by cTTE dropped to grade 1 or negative, which verified that right-to-left shunt was correlated
to PFO. After percutaneous closure for PFO for 1 week, the detection rate of right-to-left shunt of PFO was 46.3%
after Valsalva manoeuvre. Conclusion CTTE has unique value in detecting right-to-left shunt of PFO, and it is a
beneficial supplement for TTE and TEE.

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参考文献:

  • 2008

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