Pitfalls in Diagnosing PFO: Characteristics of False-Negative Contrast Injections during Transesophageal Echocardiography in Patients with Patent Foramen Ovales
Pitfalls in Diagnosing PFO: Characteristics of False-Negative Contrast Injections during Transesophageal Echocardiography in Patients with Patent Foramen Ovales
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DOI：
10.1016/j.echo.2010.08.004
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发表时间：
2010-11-01
影响因子：
6.5
通讯作者：
Dellborg, Mikael
中科院分区：
文献类型：
--
作者：
Johansson, Magnus C.;Eriksson, Peter;Dellborg, Mikael
背景：在经食管超声心动图检测卵圆孔未闭 (PFO) 期间注射造影剂可能会出现假阴性。回顾性研究假阴性注射的特点。方法：分析经食管超声心动图是否存在房间隔向左膨出和右心房邻近房间隔区域造影剂浓密充盈两种特征。结果：14例PFO患者共注射247次，假阴性130例（53%）。单次注射过程中任一特征的缺失都会导致 PFO 检测的灵敏度低至 7%。当这两个特征同时存在时，单次注射后检测PFO的灵敏度高达95%。结论：同时存在房间隔向左膨出和右心房邻近房间隔区域造影剂浓密充盈是PFO检测的先决条件，如果缺少其中任何一个特征，则注射无法得出结论。 （J Am Soc Echocardiogr 2010；23：1136-42。）
Background: Contrast injections during transesophageal echocardiography for patent foramen ovale (PFO) detection may be false negative. The characteristics of false-negative injections were studied retrospectively.Methods: Contrast transesophageal echocardiography was analyzed for the presence or absence of two characteristics: leftward bulging of the interatrial septum and dense contrast filling of the region of the right atrium adjacent to the interatrial septum.Results: Two hundred forty-seven injections were administered to 14 patients with PFOs, and 130 (53%) were false negative. The absence of either characteristic during a single injection resulted in low sensitivity for PFO detection of 7%. When the two characteristics were present at the same time, the sensitivity for PFO detection after a single injection was as high as 95%.Conclusions: The simultaneous presence of both leftward bulging of the interatrial septum and dense contrast filling of the region in the right atrium, adjacent to the interatrial septum, is a prerequisite for PFO detection, and if either characteristic is missing, the injection is inconclusive. (J Am Soc Echocardiogr 2010; 23: 1136-42.)