经食管超声心动图与双源冠状动脉CT血管造影对卵圆孔未闭右向左分流的诊断价值

摘要/Abstract

摘要： 目的探讨与分析经食管超声心动图与双源冠状动脉CT血管造影对卵圆孔未闭（patent foramen ovale,PFO）右向左分流（right-to-left shunt,RLS）的诊断价值。方法 2020年4月—2023年5月选择在南通大学第二附属医院诊治的心血管疾病患者210例作为研究对象,所有患者都给予经食管超声心动图与双源冠状动脉CT血管造影检查,记录影像学特征,并且所有患者都给予病理检查并判断诊断价值。结果在210例患者中,确诊为卵圆孔未闭右向左分流42例（PFO组）,占比20.00%。PFO组的左心房直径、肺动脉压力明显高于非PFO组（P<0.05）,左心室射血分数与非PFO组对比明显降低（P<0.05）。在210例患者中,经食管超声心动图诊断为卵圆孔未闭右向左分流46例,其中Ⅰ级28例、Ⅱ级10例、Ⅲ级8例,经食管超声心动图诊断卵圆孔未闭右向左分流的敏感度与特异度分别为97.62%（41/42）、97.02%（163/168）。双源冠状动脉CT血管造影诊断为卵圆孔未闭右向左分流43例,双源冠状动脉CT血管造影诊断卵圆孔未闭右向左分流的敏感度与特异度分别为100.00%（42/42）、99.40%（167/168）。ROC曲线显示经食管超声心动图与双源冠状动脉CT血管造影对卵圆孔未闭右向左分流的诊断最大曲线下面积为0.875、0.882。结论相对于经食管超声心动图,双源冠状动脉CT血管造影对卵圆孔未闭右向左分流的诊断效果更好。

关键词: 经食管超声心动图, 卵圆孔未闭, 右向左分流, 双源冠状动脉CT血管造影, 敏感度, 特异度

Abstract: Objective To explore and analysis the diagnostic values of transesophageal echocardiography and dual source coronary CT angiography in right to left shunt (RLS) of patent foramen ovale (PFO). Methods From April 2020 to May 2023, 210 cases of cardiovascular disease patients diagnosed and treated at a certain hospital were selected as the research subjects. All patients were underwent transesophageal echocardiography and dual source coronary artery CT angiography, and imaging features were recorded. And all patients were undergone pathological examination and diagnostic value were calculated. Results In the 210 patients, there were 42 cases were diagnosed with right to left shunt of patent foramen ovale (PFO group), accounting for 20.0%. The left atrial diameter and pulmonary artery pressure in the PFO group were significantly higher than those in the non PFO group (P<0.05), and the left ventricular ejection fraction were significantly reduced compared to the non PFO group (P<0.05). In the 210 patients, there were 46 cases diagnosed with right to left shunt of patent foramen ovale by transesophageal echocardiography, including 28 cases of grade Ⅰ, 10 cases of grade Ⅰ, and 8 cases of grade Ⅲ. The sensitivity and specificity of transesophageal echocardiography in diagnosing right to left shunt of patent foramen ovale were 97.62% (41/42) and 97.02% (163/168), respectively. And there were 43 cases of right to left shunt of patent foramen ovale were diagnosed by dual source coronary artery CT angiography. The sensitivity and specificity of dual source coronary artery CT angiography in diagnosing right to left shunt of patent foramen ovale were 100.00% (42/42) and 99.40% (167/168), respectively. The ROC curve shows the maximum area under the curve of transesophageal CT angiography with double source coronary CT angiography of 0.875 and 0.882, and it has a certain degree of accuracy. Conclusion Compared to transesophageal echocardiography, dual source coronary artery CT angiography has a better diagnostic effect on right to left shunt of patent foramen ovale.

Key words: transesophageal echocardiography, patent foramen ovale, right to left diversion, dual source coronary artery CT angiography, sensitivity, specificity

中图分类号:

R541.1

丁冰倩. 经食管超声心动图与双源冠状动脉CT血管造影对卵圆孔未闭右向左分流的诊断价值[J]. 中华养生保健, 2024, 42(9): 177-179.

Ding Bing-qian. Diagnostic values of transesophageal echocardiography and dual source coronary artery CT angiography in right to left shunt of patent foramen ovale[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(9): 177-179.

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