中国卒中杂志2016，Vol.11Issue(9)：752-757,6.DOI:10.3969/j.issn.1673-5765.2016.09.008
经颅多普勒增强实验结合经食管超声鉴别肺动静脉瘘与卵圆孔未闭所致隐源性卒中的研究
The Significance of Contrast Transcranial Doppler Combined with Transesophageal Echocardiography in the Differential Diagnosis of Cryptogenic Stroke with Pulmonary Arteriovenous Fistula and Patent Foramen Ovale
董培 1潘华1
作者信息
- 1. 100050 北京首都医科大学附属北京天坛医院临床神经生理科
- 折叠
摘要
Abstract
Objective To explore the significance of contrast transcranial Doppler (cTCD) combined with transesophageal echocardiography (TEE) in the differential diagnosis of cryptogenic stroke with pulmonary arteriovenous ifstula and patent foramen ovale. Methods Detailed clinical information were collected. TEE and cTCD were performed in 4 patients with cryptogenic stroke (2 patients with pulmonary arteriovenous fistula [PAVF] and 2 patients with patent foramen ovale [PFO]) to compare the difference in test results. Results cTCD in 2 patients with PAVF showed the following characteristics: detection of massive microembolic signals (curtain pattern) during regular breathing, and not influenced by Valsalva maneuver (VM). TEE showed large number of microbubbles appeared in the left atrium at 5th cardiac cycle after VM. cTCD in 2 patients with PFO showed: detection of none or 4 signals during regular breathing, and curtain pattern of signals after VM. TEE with color Doppler imaging showed left-to right shunt and several microbubbles appeared in the left atrium at 2nd-3rd cardiac cycle after VM. Conclusion cTCD combined with TEE is useful for differential diagnosis of PFO and PAVF due to high sensitivity and easy operation. The main identiifcation points is that whether there are lots of massive microembolic signals and whether it will be inlfuenced by VM at cTCD during regular breathing.关键词
肺动静脉瘘/卵圆孔未闭/隐源性卒中/经颅多普勒Key words
Pulmonary arteriovenous fistula/Patent foramen ovale/Cryptogenic stroke/Transcranial Doppler引用本文复制引用
董培,潘华..经颅多普勒增强实验结合经食管超声鉴别肺动静脉瘘与卵圆孔未闭所致隐源性卒中的研究[J].中国卒中杂志,2016,11(9):752-757,6.
