经颅多普勒超声发泡试验筛查卵圆孔未闭致隐源性脑卒中的应用价值

毛樱; 王芳; 池菊芳; 钟芳芳

doi:10.16766/j.cnki.issn.1674-4152.002513

经颅多普勒超声发泡试验筛查卵圆孔未闭致隐源性脑卒中的应用价值

doi: 10.16766/j.cnki.issn.1674-4152.002513

毛樱¹,
王芳^1, ,,
池菊芳²,
钟芳芳³

1.
绍兴市人民医院特殊检查室，浙江绍兴 312000
2.
绍兴市人民医院心内科，浙江绍兴 312000
3.
绍兴市人民医院神经内科，浙江绍兴 312000

基金项目:

浙江省卫生健康科技计划项目 2021KY360

详细信息

通讯作者:
王芳，E-mail：cmk5678112@163.com

中图分类号: R743.3 R445.1
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- 文章访问数: 141
- HTML全文浏览量: 93
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2021-12-03
- 网络出版日期: 2022-09-21

Application value of transcranial Doppler ultrasound foaming test in screening cryptogenic stroke caused by patent foramen ovale

1.
Special Examination Room of Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的分析经颅多普勒超声发泡试验(C-TCD)筛查卵圆孔未闭(PFO)致隐源性脑卒中(CS)的应用价值。方法选取2017年1月—2021年6月绍兴市人民医院收治的204例CS患者，所有患者均行C-TCD与经食管超声心动图(TEE)检查，比较其PFO阳性检出率；根据C-TCD的PFO检出情况，将阳性者纳入阳性组，阴性者纳入阴性组，分析阳性组患者的微气泡信号分级，比较2组患者的血管分布区影像特征(前循环、后循环、前后联合循环、大脑前动脉、大脑中动脉、椎基底动脉)及各区域影像学特征(皮层/皮层下区域、深部灰质区域、幕下区域)。结果 C-TCD的PFO阳性检出率为55.39%(113/204)，高于TEE检查[42.65%(87/204)，P＜0.05]。C-TCD检出PFO阳性113例，其中包括0级26例(23.01%)，Ⅰ级34例(30.09%)，Ⅱ级27例(23.89%)，Ⅲ级26例(23.01%)。阳性组与阴性组前循环、后循环、前后联合循环、大脑前动脉、大脑中动脉、椎基底动脉的分布比较差异无统计学意义(均P＞0.05)。阳性组皮层/皮层下区域的检出率为57.52%，高于阴性组的27.59%(P＜0.05)；阳性组深部灰质区域的检出率为22.12%，低于阴性组的40.23%(P＜0.05)；阳性组幕下区域的检出率为14.16%，与阴性组的16.09%相近(P＞0.05)。结论 C-TCD在PFO致CS筛查中可发挥一定的作用，患者病变多分布于皮层/皮层下区域，可作为CS病因筛查手段。
- 经颅多普勒超声发泡试验 /
- 卵圆孔未闭 /
- 隐源性脑卒中 /
- 筛查 /
- 应用价值
Abstract: Objective To analyse the application value of transcranial Doppler ultrasound foaming test (C-TCD) in screening cryptogenic stroke (CS) caused by patent foramen ovale (PFO). Methods A total of 204 patients with CS treated in Shaoxing People's Hospital from January 2017 to June 2021 were examined by C-TCD and transoesophageal echocardiography (TEE), and the positive detection rate of PFO was compared. According to the PFO detection of C-TCD, the positive patients were included in the positive group, and the negative patients in the negative group. The microbubble signal classification of the patients in the positive group was analysed, and the imaging characteristics of the vascular distribution areas (anterior circulation, posterior circulation, combined anterior and posterior circulation, anterior cerebral artery, middle cerebral artery and vertebrobasilar artery) and each region were compared between the two groups. Results The positive rate of PFO in C-TCD was 55.39% (113/204), which was higher than that in TEE (42.65%, 87/204, P < 0.05). A total of 113 cases of PFO were positive in C-TCD, including 26 cases of grade 0 (23.01%), 34 cases of grade Ⅰ (30.09%), 27 cases of grade Ⅱ (23.89%) and 26 cases of grade Ⅲ (23.01%). There was no significant difference in the distribution of anterior circulation, posterior circulation, combined anterior and posterior circulation, anterior cerebral artery, middle cerebral artery and vertebrobasilar artery in the positive and negative groups (P>0.05). The detection rate of cortical/subcortical area in the positive group was 57.52%, which was higher than that in the negative group (27.59%), P < 0.05. The detection rate of deep grey matter in the positive group was 22.12%, which was lower than that in the negative group (40.23%), P < 0.05. The detection rate of infratentorial area in the positive group was 14.16%, which was close to that in the negative group (16.09%), P>0.05. Conclusion C-TCD has a certain application value in the screening of CS caused by PFO. Patients' lesions are mostly distributed in cortical/subcortical areas, which can be used as a means of screening the aetiology of CS.
- Contrast transcranial Doppler ultrasound foaming test /
- Patent foramen ovale /
- Cryptogenic stroke /
- Screening /
- Application value

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表 1 2组隐源性脑卒中患者血管分布区影像特征比较[例(%)]

Table 1. Comparison of image characteristics of vascular distribution area in 2 groups of cryptogenic stroke patients [cases (%)]

组别	例数	前循环	后循环	前后联合循环	大脑前动脉	大脑中动脉	椎基底动脉
阳性组	113	66(58.41)	41(36.28)	9(7.96)	8(7.08)	57(50.44)	41(36.28)
阴性组	87	49(56.32)	30(34.48)	8(9.20)	6(6.90)	43(49.43)	30(34.48)
χ²值		0.087	0.070	0.096	0.003	0.020	0.070
P值		0.767	0.792	0.757	0.960	0.887	0.792

下载: 导出CSV

表 2 2组隐源性脑卒中患者各区域影像学特征比较[例(%)]

Table 2. Comparison of imaging characteristics of each region in 2 groups of cryptogenic stroke patients [cases (%)]

组别	例数	皮层/皮层下区域	深部灰质区域	幕下区域
阳性组	113	65(57.52)	25(22.12)	16(14.16)
阴性组	87	24(27.59)	35(40.23)	14(16.09)
χ²值		17.836	7.673	0.144
P值		＜0.001	0.006	0.704

下载: 导出CSV

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