Contrastive analysis of real-time three-dimensional echocardiography combined with right ventricular contrast echo-cardiography in the diagnosis of adult patent foramen ovale without dysmenorrhea

DU Yuanzhang; WANG Xiaojing; GAO Bai

doi:10.20258/j.cnki.1006-9011.2025.09.012

Abstract：Objective To analyze the diagnostic efficacy of painless transesophageal real-time three-dimensional echocar-diography combined with right heart contrast echocardiography in adults with patent foramen ovale(PFO)and the impact of right-to-left shunt in the heart.Methods A total of 75 adult patients with PFO were selected.All patients underwent transthoracic contrast echocardiography(cTTE),transesophageal two-dimensional echocardiography(2D TEE),and transesophageal three-dimensional echocardiography(3D TEE).We compared the impact of three examination methods,i.e.,transesophageal 2D TEE combined with right heart contrast,3D TEE combined with right heart contrast,and right heart contrast,on the detection rate of PFO.The differences in emi-quantitative grading of right-to-left shunt(RLS),the tunnel length and diameter of PFO between the combination of 2D TEE with right heart contrast echocardiography,and the combination of 3D TEE with right heart contrast echo-cardiography were compared.Results The detection rate of PFO by the combination of 3D TEE and cTTE was 100.00%(75/75),which was significantly higher than 90.67%(68/75)of the combination of 2D TEE and right heart contrast echocardiogra-phy(t=8.66,P<0.05).In terms of RLS grading,the combination of 3D TEE with right heart contrast had a higher detection rate for grade Ⅰ and grade Ⅱ shunts compared to 2D TEE with right heart contrast(χ2=1.33,P<0.05),but there was no significant difference in the detection rate of grade Ⅲ shunts compared with other examinations(t=0.55,P>0.05).The tunnel length of PFO diagnosed by the combination of 2D TEE and right heart contrast echocardiography was shorter than that by the combination of 3D TEE and right heart contrast echocardiography(t=1.95,P<0.05),while,there was no significant difference in the measure-ment of PFO diameter between these two examination methods(t=1.75,P>0.05).Conclusion Painless transesophageal three-dimensional echocardiography combined with transthoracic right heart contrast echocardiography has a high accuracy in diagnos-ing PFO.This can effectively evaluate the size of PFO and the RLS shunt,thereby providing strong support for clinical diagnosis and treatment.However,this study has limitations,such as a small sample size.