通过变方体多普勒对右向左顺差进行分级:在患有密码性中风的患者中是一种有效的方法
Beatriz Martínez García1, Juan Luis Chico García1, Daniel Pérez Gil1
1Stroke Comprehensive Center, Department of Neurology, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Ramón y Cajal, Madrid, Spain.
概括
变形外跨多普勒 (TCD) 是一种有效的方法来诊断从右到左的分流 (RLS),显示与跨食道心声图的良好一致. 这种技术有助于识别那些可能从专利孔圆形关闭中受益最多的患者.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- 往往由于 patent foramen ovale (PFO) 而导致的右向左偏移 (RLS) 是年轻成年人密码性中风 (CS) 的关键原因.
- 使用激动盐水的跨多普勒 (TCD) 对于通过跨 (TTD) 方法检测RLS是敏感的.
- 一些患者对TTD的骨窗口不足.
研究的目的:
- 为了评估转发性TCD (TFD) 诊断RLS的准确性.
- 为了比较TFD与跨时性TCD (TTD) 和跨食道心声图 (TEE).
主要方法:
- 患有CS或TIA的患者使用TFD和TTD协议进行了RLS测试.
- 在TFD和TEE之间的RLS分级的一致性使用加权的kappa进行了评估.
- 直接比较了TTD和TFD方法.
主要成果:
- 分析了40名患者;70%的患者在TTD上有中/大RLS,在TFD上有67.5%.
- 在82.6%的病例中,TEE证实了中型/大型PFO.
- 在RLS分级方面,TFD和TEE之间 (kappa=0.684) 和TTD和TFD之间 (kappa=0.73) 发现了很高的一致性.
结论:
- 变形体TCD (TFD) 是一种验证的RLS诊断方法.
- 在RLS的分级方面,TFD与TEE达成了实质性的协议.
- 包括TFD在内的TCD可以识别具有显著RLS的患者,这些患者是PFO关闭的候选人.
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