Transcranial Doppler ultrasonography should it be the first choice for persistent foramen ovale screening?
Transcranial Doppler ultrasonography should it be the first choice for persistent foramen ovale screening?
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经颅多普勒超声检查是否应该是持续的卵子筛选的首选？
DOI：
10.1186/1476-7120-12-16
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发表时间：
2014-05-22
影响因子：
1.9
通讯作者：
Podolec P
中科院分区：
文献类型：
--
作者：
Komar M;Olszowska M;Przewłocki T;Podolec J;Stępniewski J;Sobień B;Badacz R;Kabłak-Ziembicka A;Tomkiewicz-Pająk L;Podolec P
持续性卵圆孔(PFO)被认为是隐源性中风的原因，也是年轻患者发生神经事件的危险因素。确定PFO的参考标准是经食道超声心动图(TEE)。本研究的目的是评价经颅彩色多普勒(TCD)的可行性及其诊断敏感性，并与TEE进行比较。我们调查了我科收治的420名有隐源性中风、短暂性脑缺血发作或其他神经症状的患者。所有患者均行TCD和TEE检查。TCD和TEE检查按标准化程序进行：右侧肘前静脉注入混气生理盐水3次，并在Valsalva动作时记录多普勒信号。在经颅多普勒检查中，记录造影剂进入右侧大脑中动脉的时间为Valsalva动作后25秒。在TCD和TEE患者中，220例(52.3%)检测到从右向左分流，159例(37.9%)无分流。20例(4.8%)TEE未显示对比剂通道，TCD检测到对比剂通道。在21例(5.0%)患者中，仅TEE显示了PFO。两种方法的可行性均为100%。TCD诊断PFO的敏感性为95%，特异性为92%。TCD具有较好的敏感性和特异性。TCD和TEE是诊断PFO的补充检查，但TCD具有简便、无创性、低成本、可行性高等优点，应作为首选筛查方法。
Persistent foramen ovale (PFO) is considered a cause of cryptogenic stroke and a risk factor for neurological events in young patients. The reference standard for identifying a PFO is contrast-enhanced transesophageal echocardiography (TEE). The goal of this study was to evaluate the feasibility of transcranial color Doppler (TCD) and its diagnostic sensitivity compared with TEE. We investigated 420 patients admitted to our department with cryptogenic stroke, transient ischemic attacks or other neurological symptoms. All patients underwent TCD and TEE evaluation. TCD and TEE examinations were performed according to a standardized procedure: air-mixed saline was injected into the right antecubital vein three times, while the Doppler signal was recorded during the Valsalva maneuver. During TCD the passage of contrast into the right-middle cerebral artery was recorded 25 seconds following the Valsalva maneuver. We detected a right-to-left shunt in 220 patients (52.3%) and no-shunts in 159 patients (37.9%) with both TCD and TEE. In 20 (4.8%) patients TEE did not reveal contrast passage which was then detected by TCD. In 21 (5.0%) patients only TEE revealed a PFO. The feasibility of both methods was 100%. TCD had a sensitivity of 95% and a specificity of 92% in the diagnosis of PFO. TCD has a relatively good sensitivity and specificity. TCD and TEE are complementary diagnostic tests for PFO, but TCD should be recommended as the first choice for screening because of its simplicity, non-invasive character, low cost and high feasibility.
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影响因子：
8.3
作者：
Droste, DW;Lakemeier, S;Ringelstein, B
通讯作者：
Ringelstein, B
影响因子：
4.8
作者：
Fox, ER;Picard, MH;Kerr, AJ
通讯作者：
Kerr, AJ
影响因子：
--
作者：
Hamilton-Craig, C.;Sestito, A.;Lanza, G. A.
通讯作者：
Lanza, G. A.
影响因子：
9.9
作者：
KLOTZSCH, C;JANSSEN, G;BERLIT, P
通讯作者：
BERLIT, P
影响因子：
8.3
作者：
Droste, DW;Silling, K;Ringelstein, EB
通讯作者：
Ringelstein, EB