两种造影剂在经颅多普勒超声诊断卵圆孔未闭中的诊断阳性率对比

发布时间：2018-01-03 07:43

  本文关键词：两种造影剂在经颅多普勒超声诊断卵圆孔未闭中的诊断阳性率对比　出处：《南方医科大学学报》2016年08期 　论文类型：期刊论文

  更多相关文章： 造影剂 经颅多普勒超声 卵圆孔未闭 右向左分流

【摘要】：目的比较生理盐水-气体混合液(AS)和生理盐水-气体-血混合液(ASb)这两种造影剂在经颅多普勒超声(c-TCD)诊断卵圆孔未闭(PFO)方面的差异。方法收集2015年11月~2016年1月在我院TCD室行c-TCD检查患者248例,通过掷硬币法决定AS或ASb这两种造影剂使用的先后顺序。然后分别均在不伴Valsalva动作(VM)与伴VM情况下,注入造影剂(CA),通过观察TCD频谱,记录CA注射后25 s内微泡数目及第一个微泡出现的时间。具体操作方法如下:(1)9 m L生理盐水混合1 m L空气不伴VM(AS不伴VM);(2)9 m L生理盐水混合1 m L空气伴VM(AS伴VM);(3)9 m L生理盐水、1滴患者回抽血液混合1 m L空气不伴VM(ASb不伴VM);(4)9 m L生理盐水、1滴患者回抽血液混合1 m L空气伴VM(ASb伴VM)。上述每种方法重复2次,且每个过程间隔至少5 min。根据微泡数量对PFO分流程度进行分级:0级,阴性;Ⅰ级,1~10个微泡;Ⅱ级,10个微泡但未形成"雨帘";Ⅲ级,形成雨帘状。结果 AS不伴VM、AS伴VM、ASb不伴VM和ASb伴VM检查的阳性率分别是10.9%、23.8%、12.1%、25.8%。AS伴VM组发泡阳性率较AS不伴VM组显著增高,具有统计学差异(23.8%vs 10.9%,P=0.001);ASb伴VM组发泡阳性率较ASb不伴VM组显著增高,具有统计学差异(25.8%vs 12.1%,P=0.001);ASb不伴VM组发泡阳性率与AS不伴VM组相比差异无统计学意义(12.1%vs 10.9%,P=0.250);ASb伴VM组发泡阳性率与AS伴VM组相比差异无统计学意义(25.8%vs 23.8%,P=0.125)。结论应用c-TCD检测PFO时VM能够提高诊断阳性率,而AS与ASb这两种造影剂在诊断PFO阳性率方面无明显差异。
[Abstract]:Objective to compare the diagnosis of PFOO with normal saline gas mixture (ASB) and saline gas blood mixture (ASB) in transcranial Doppler echocardiography (TCD) in the diagnosis of unobturated foramen ovale (PFOO). Methods from November 2015 to January 2016, 248 patients were examined with c-TCD in our TCD room. The order of use of as or ASb was determined by coin toss method. Then the contrast agent was injected without Valsalva and VM respectively. By observing the TCD spectrum. The number of microbubbles and the time of occurrence of the first microbubble were recorded 25 seconds after CA injection. ; (2) 9 mL normal saline mixed with 1 mL air with VM(AS with VMN; One drop of 9 mL normal saline was used to draw back blood and mixed 1 mL air without VM(ASb without VMN. The blood was mixed with VM(ASb and VMN in patients with 9 mL normal saline and 1 drop of blood. Each of the above methods was repeated twice. According to the number of microbubbles, the PFO shunt degree was graded into grade 0: 0 and negative. Grade I 1 ~ 10 microbubbles; Grade 鈪，

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