The value of dual source coronary CT angiography in diagnosis of patent foramen ovale

LIU Yijin; ZHENG Chong; GENG Wenlei; SUN Lijie; LI Jing; LU Jie

Abstract：Objective To evaluate the value of dual-source coronary CT angiography(CCTA)in the diagnosis of patent fora-men ovale(PFO).Methods The clinical data of 99 suspected patients with PFO were retrospectively collected and analyzed.The assessment of PFO by CCTA was determined and compared with the assessment by TEE as the gold standard.Dual source CT was used to measure the length of the free flap valve(FV)consisting of the primary septum,the width of the PFO,the height of the PFO,the length of the secondary septum,the thickness of the secondary septum,and the diameter of the oval fossa(FO).Results Among the 99 patients,PFO was found in 82 patients accounting for 82.8％of the total patients.Among them,30.5％of patients presented without shunts and 69.5％of patients with shunts.Furthermore,42.7％presented with grade Ⅰ shunt,20.7％with grade Ⅱ shunt,and 6.1％with grade Ⅲ shunt.The FV was(1.23±0.28)cm,the width of PFO was(1.19±0.46)cm,the height was(0.17±0.04)cm,the width of right atrium entrance of PFO channel was(0.18±0.08)cm,the thickness of IAG was(0.74±0.23)cm,the length was(1.58±0.41)cm,and the diameter of FO was(1.41±0.39)cm.Among the 99 pa-tients,PFO was found in 89 patients by TEE.The sensitivity,specificity,accuracy,positive predictive value,and negative pre-dictive value of CCTA for detecting PFO were 92.1％,100％,92.9％,100％,and 58.8％,respectively.In the PFO diagnosis,the CCTA and TEE results were highly consistent,with a Kappa value of 0.892.Conclusion This study finds that CCTA examina-tion can provide anatomical details on the size and morphologic features of PFO and its shunts,thereby offering the evaluation be-fore PFO occlusion with imaging evidence.