Purvis John A, Morgan David R, Hughes Sinead M
Cardiac Unit, Altnagelvin Hospital, Western HSC Trust, Glenshane Road, Londonderry BT47 6SB, United Kingdom.
Ulster Med J. 2011 May;80(2):72-5.
A patent foramen ovale (PFO) is strongly associated with cryptogenic stroke (CS), neurological and other phenomena. The reported prevalence of PFO varies according to the imaging technique used and population studied.
To measure prospectively, the prevalence of PFO in a cohort of consecutive patients attending for routine "coronary" CT angiography using standard, everyday coronary protocols including low-dose prospective ECG gated studies.
Standard coronary imaging protocols were used. PFOs were graded according to the classification of Williamson et al.
261 patients were studied. A PFO was identified in 22.6% (11.5% grade 1 (closed flap), 6.5% grade 2 (open flap) and 4.6% grade 3 (open flap with jet)). A further 6.1% had an atrial septal aneurysm.
The prevalence of all grades of PFO (22.6%) and open flap PFO (11.1% = grade 2 and 3) with this technique compares with 24.3% by trans-oesophageal echocardiography (TOE) and 14.9% by saline contrast echocardiography (SCE). Further comparative studies are required but we believe an open flap PFO or ASA should be identified and recorded during cardiac CT. This approach may identify those at risk of cryptogenic stroke as well as avoid unnecessary tests in stroke patients.
卵圆孔未闭（PFO）与不明原因卒中（CS）、神经系统及其他现象密切相关。报道的PFO患病率因所使用的成像技术和研究人群而异。
前瞻性测量一组连续接受常规“冠状动脉”CT血管造影的患者中PFO的患病率，采用标准的日常冠状动脉检查方案，包括低剂量前瞻性心电图门控研究。
使用标准冠状动脉成像方案。根据威廉姆森等人的分类对PFO进行分级。
共研究了261例患者。发现22.6%的患者存在PFO（11.5%为1级（瓣叶闭合），6.5%为2级（瓣叶开放），4.6%为3级（有分流的瓣叶开放））。另有6.1%的患者存在房间隔瘤。
采用该技术所有级别PFO的患病率（22.6%）及开放瓣叶PFO（11.1%=2级和3级）与经食管超声心动图（TOE）测得的24.3%及盐水对比超声心动图（SCE）测得的14.9%相比。需要进一步的对比研究，但我们认为在心脏CT检查期间应识别并记录开放瓣叶PFO或房间隔瘤。这种方法可能识别出不明原因卒中的高危人群，并避免对卒中患者进行不必要的检查。
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