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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Patent foramen ovale: detection with nongated multidetector CT
Marie-Pierre Revel1, Jean-Baptiste Faivre, Thierry Letourneau
1Department of Radiology, Calmette Hospital, Centre Hospitalier Regional Universitaire de Lille, University of Lille-2, Boulevard Jules Leclercq, 59037 Lille, France.
Radiology
|September 18, 2008
Summary
Nongated multidetector CT effectively detects high-grade patent foramen ovale (PFO) shunts with 91% sensitivity and 98% specificity. This imaging technique may aid in diagnosing unexplained hypoxemia by identifying PFO.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Patent foramen ovale (PFO) is a potential cause of cryptogenic stroke.
- Transesophageal echocardiography (TEE) is a standard method for PFO detection.
- Nongated multidetector computed tomography (CT) offers an alternative imaging modality.
Purpose of the Study:
- To compare the diagnostic performance of nongated multidetector CT with TEE for detecting PFO and atrial septal aneurysm (ASA).
- To assess the accuracy of CT in identifying PFO in patients with recent stroke.
Main Methods:
- 105 patients with recent stroke underwent same-day TEE and nongated multidetector CT.
- CT involved contrast injection and Valsalva maneuver during image acquisition.
- PFO was identified on CT by visual assessment of left atrial enhancement or time-attenuation curve analysis.
Main Results:
- Nongated CT demonstrated 98% specificity for PFO detection.
- Overall sensitivity for PFO detection was 55%, with higher sensitivity (91%) for high-grade shunts (grade 4).
- CT visualized only 22% of ASA cases; mean effective radiation dose was 2.3 mSv.
Conclusions:
- Nongated multidetector CT is a specific tool for diagnosing high-grade PFO shunts.
- CT may be valuable for PFO detection in patients with unexplained hypoxemia, complementing lung evaluations.
- Further investigation into CT's role in PFO diagnosis is warranted.
