摘要
目的分析右心声学造影(RCAC)联合经颅多普勒超声(TCD)诊断成人卵圆孔未闭(PFO)的价值。方法回顾性抽取2023年1月至2023年12月郑州市第九人民医院收治的62例疑似成人PFO患者为研究对象,均行RCAC、TCD检查。以经食管心脏超声(TEE)检查结果为"金标准",比较RCAC、TCD、RCAC联合TCD对成人PFO的诊断结果和诊断效能;比较RCAC、TCD诊断成人PFO合并和未合并偏头痛的阳性率。结果本组62例疑似成人PFO患者,采用TEE检查确诊阳性48例,阴性14例;采用RCAC检查诊断出真阳性38例,真阴性10例;采用TCD检查诊断出真阳性37例,真阴性11例;采用RCAC联合TCD检查诊断出真阳性46例,真阴性13例。RCAC联合TCD诊断灵敏度、准确度(95.83%,46/48;95.16%,59/62)高于RCAC(79.17%,38/48;77.42%,48/62)和TCD诊断(77.08%,37/48;77.42%,48/62),漏诊率(4.17%,2/48)低于RCAC(20.83%,10/48)和TCD诊断(22.92%,11/48),P<0.05。48例成人PFO患者中合并偏头痛32例,未合并偏头痛16例,RCAC诊断阳性率与TCD诊断阳性率比较差异未见统计学意义(P>0.05)。结论RCAC联合TCD诊断成人PFO可提高诊断灵敏度和准确度,减少漏诊情况的发生,且PFO引发的心脏右向左分流与偏头痛的发生和进展密切相关,临床可积极进行RCAC联合TCD检查,以提升疾病检出率。
ObjectiveTo analyze the value of right heart contrast echocardiography(RCAC)combined with transcranial Doppler ultrasound(TCD)in the diagnosis of patent foramen ovale(PFO)in adults.MethodsA total of 62 adult patients with suspected PFO treated in Ninth People’s Hospital of Zhengzhou from January 2023 to December 2023 were retrospectively selected as the research objects,and they all underwent RCAC and TCD examinations.Taking the transesophageal echocardiography(TEE)results as the gold standard,the diagnostic results and diagnostic efficacy of RCAC,TCD,and RCAC combined with TCD for PFO in adults were compared.The positive rates of RCAC and TCD in the diagnosis of adult PFO with and without migraine were compared.ResultsAmong the 62 adult patients with suspected PFO,48 cases were positive and 14 cases were negative according to TEE examination.RCAC identified 38 cases of true positive and 10 cases of true negative.TCD identified 37 cases of true positive and 11 cases of true negative.RCAC combined with TCD identified 46 cases of true positive and 13 cases of true negative.The sensitivity and accuracy of RCAC combined with TCD(95.83%,46/48;95.16%,59/62)were higher than those of RCAC diagnosis(79.17%,38/48;77.42%,48/62)and TCD diagnosis(77.08%,37/48;77.42%,48/62),while the missed diagnosis rate(4.17%,2/48)was lower than that of RCAC(20.83%,10/48)and TCD(22.92%,11/48),P<0.05.Among the 48 PFO adults,32 cases were accompanied by migraine,and 16 cases were not accompanied by migraine.There was no significant difference in the positive rate between RCAC diagnosis and TCD diagnosis(P>0.05).ConclusionsThe combination of RCAC and TCD in the diagnosis of adult PFO can improve the diagnostic sensitivity and accuracy,reduce the occurrence of missed diagnosis.Moreover,the right-to-left shunt of the heart caused by PFO is closely related to the occurrence and progression of migraine.RCAC combined with TCD can be actively performed in clinical practice to improve the detection rate of disease.
作者
贾晓慧
舒娜
Jia Xiaohui;Shu Na(Department of Function,Ninth People’s Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《中国实用医刊》
2024年第21期69-72,共4页
Chinese Journal of Practical Medicine
关键词
卵圆孔未闭
偏头痛
右心声学造影
经颅多普勒超声
成人
Foramen ovale,patent
Migraine disorders
Right heart contrast transthoracic echocardiography
Transcranial Doppler
Adult
