Application of Contrast-Enhanced Transcranial Doppler Ultrasound (c-TCD) Combined with Contrast-Enhanced Transthoracic Echocardiography (c-TTE) in Screening for Right-to-Left Shunt in Patent Foramen Ovale (PFO)
Abstract：Objective: To investigate the application value of contrast-enhanced transcranial Doppler ultrasound (c-TCD) combined with contrast-enhanced transthoracic echocardiography (c-TTE) in screening for right-to-left shunt (RLS) in patent foramen ovale (PFO). Methods: A total of 106 patients suspected of PFO-RLS who were admitted to the Department of Ultrasonic Diagnosis at Xinyang Central Hospital from October 2021 to December 2023 were selected as the study subjects. All suspected patients underwent contrast-enhanced transesophageal echocardiography (c-TEE), c-TCD, and c-TTE examinations. The diagnostic efficacy and grading accuracy of c-TCD, c-TTE, and their combination for PFO-RLS were evaluated, with c-TEE serving as the gold standard. Results: With c-TEE as the gold standard, the Kappa values for diagnosing PFO-RLS by c-TCD, c-TTE, and the combined examination were 0.696, 0.753, and 0.831, respectively. The sensitivity of the combined examination was higher than that of c-TEE and c-TCD (χ²=6.061, 7.950, P=0.014, 0.005). Among the 50 patients with PFO-RLS, c-TEE detected 8 cases (16.00%) of grade 1 shunt, 28 cases (56.00%) of grade 2 shunt, and 14 cases (28.00%) of grade 3 shunt. There was no statistically significant difference in the detection rates of PFO-RLS among grades 1, 2, and 3 between c-TCD, c-TTE, and the combined examination (P>0.05). Conclusion: The combined examination of c-TCD and c-TTE can improve the diagnostic efficiency of PFO-RLS.
Keywords：Patent Foramen Ovale Right-to-Left ShuntContrast-Enhanced Transcranial Doppler UltrasoundContrast-Enhanced Transthoracic EchocardiographyContrast-Enhanced Transesophageal Echocardiography
Publication Date：2025-09-30
Online Publishing Date：2025-12-22(First online date of this platform, not the publication date of the document)
Pages：4( 60-63 )