广州医药 ›› 2020, Vol. 51 ›› Issue (5): 76-78.DOI: 10.3969/j.issn.1000-8535.2020.05.017

• 论著 • 上一篇    下一篇

超声不同方法联合应用对提高卵圆孔未闭检出率的应用价值

张秀玲   

  1. 广州市第一人民医院,华南理工大学附属第二医院超声医学科 (广州 510180)
  • 收稿日期:2020-02-13 出版日期:2020-09-20 发布日期:2021-11-28
  • 基金资助:
    广东省广州市卫生健康科技项目(20191A010017);广东省广州市中医药和中西医结合科技项目(20192A 010003)

The application value of different ultrasound methods in improving the detection rate of patent foramen ovale

ZHANG Xiuling   

  1. Department of Medical Ultrasound, Guangzhou First People's Hospital,The Second Affiliated Hospital of South China University of Technology, Guangzhou 510180,China
  • Received:2020-02-13 Online:2020-09-20 Published:2021-11-28

摘要: 目的 探讨超声不同方法联合应用对提高卵圆孔未闭检出率的应用价值。方法 收集我院收治的临床疑似卵圆孔未闭的患者88例作为研究对象,进行超声影像组合检查(常规经胸超声心动图检查,经食道超声检查,右心声学造影检查),并对多组超声影像检查结果记录行回顾性统计分析。结果 88例研究对象中常规经胸超声心动图初步筛查发现PFO(+)12例(13.6%),其中合并房间隔膨出瘤2例。经食道超声检查22例,发现PFO(+)20例(90.9%),其中发现来源于肺动静脉瘘2例。全部研究对象均行右心声学造影发现PFO(+)39例(44.3%),分别于静息状态下发现PFO(+)24例,Valsalva动作后发现PFO(+)39例;其中发现合并房间隔膨出瘤形成者4例;合并肺动静脉瘘者3例(其中1例来源于肺静脉)。经食道超声联合右心声学造影检查的14例患者中发现PFO(+)10例(71.4%)。右心声学造影依据微气泡的数量进行半定量分级发现:I级有16例;II级有5例;III级有18例;不同状态下对于RLS的半定量分级差异有统计学意义(χ2=12.729,P=0.02)。结论 超声影像组合可对卵圆孔未闭患者进行半定量评估,能有效补充单一常规超声检查的信息的不足,进而为临床诊治提供客观化依据。

关键词: 卵圆孔未闭, 经胸超声心动图, 经食管超声心动图, 超声造影

Abstract: Objective To explore the value of ultrasound combined with different methods in improving the detection rate of patent foramen ovale. Methods 88 cases of clinically suspected patent foramen ovale in our hospital were collected as the research objects to carry out the ultrasonic image group examination (routine transthoracic echocardiography TTE, transesophageal echocardiography TEE, right heart contrast echocardiography), and the results of multiple groups of ultrasonic image examination were recorded for retrospective statistical analysis. Results Among 88 subjects, 12 (13.6%) were found to have PFO (+)by conventional transthoracic echocardiography, 2 of them had atrial septal aneurysm. 20 cases (90.9%) of PFO were found by transesophageal ultrasonography, and two of them were from pulmonary arteriovenous fistula.In all the subjects, 39 cases (44.3%) of PFO were found by right heart sonography, 24 cases were found in resting state, 39 cases were found after Valsalva operation, 4 cases were found with aneurysm of atrial septum, 3 cases with pulmonary arteriovenous fistula (one of them was from pulmonary vein). Among the 14 patients examined by transesophageal ultrasound combined with right cardiac sonography, 10 (71.4%) were found to have PFO(+). According to the number of microbubbles, the right echocardiography showed that there were 16 cases in grade I, 5 cases in grade II, 18 cases in grade III, and there were statistical differences in the semi quantitative classification of RLS in different states (χ2=12.729, P=0.02). Conclusion Ultrasound image histology can be used for semi quantitative evaluation of patients with patent foramen ovale, which can effectively supplement the lack of single conventional ultrasound information, and provide objective basis for clinical diagnosis and treatment.

Key words: Patent foramen ovale, Transthoracic echocardiography, Transesophageal echocardiography, Contrast echocardiography