Sun J P, Stewart W J, Hanna J, Thomas J D
Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195, USA.
Am Heart J. 1996 Feb;131(2):239-44. doi: 10.1016/s0002-8703(96)90347-6.
To ascertain the factors related to the transesophageal echocardiographic diagnosis of patent foramen ovale, the primary echocardiographic data were reviewed from 74 patients with that diagnosis. Similar detection rates were observed with contrast echocardiography (82%) and color flow mapping (78%), but contrast was more sensitive in patients with normal-sized atria (94%) and isolated right atrial enlargement (100%) than in those with enlarged left atria, all but three of whom had biatrial enlargement (52%) (p < 0.001 by chi-square test). Doppler flow mapping was less sensitive for normal-sized atria (66%) than for isolated enlarged right atria (81%) and left (bi-) atrial enlargement (96%) (p = 0.024). Patent foramen ovale was directly visualized by two-dimensional echocardiography in 80%, with close agreement to the size of the color flow jet (r = 0.90, delta = 0.1 +/- 0.4 mm); foramen ovale size was related to right atrial area (r = 0.31, p = 0.015). Thus both saline contrast and color flow imaging are necessary to exclude the diagnosis of patent foramen ovale.
为确定与经食管超声心动图诊断卵圆孔未闭相关的因素，我们回顾了74例经该诊断患者的主要超声心动图数据。对比超声心动图（82%）和彩色血流图（78%）的检出率相似，但在心房大小正常的患者（94%）和孤立性右心房扩大的患者（100%）中，对比剂比在左心房扩大的患者中更敏感，左心房扩大的患者中除3例患者外均为双心房扩大（52%）（经卡方检验，p<0.001）。多普勒血流图对正常大小心房（66%）的敏感性低于对孤立性右心房扩大（81%）和左（双）心房扩大（96%）的敏感性（p = 0.024）。二维超声心动图直接显示卵圆孔未闭的比例为80%，与彩色血流束大小密切相关（r = 0.90，差值 = 0.1±0.4 mm）；卵圆孔大小与右心房面积相关（r = 0.31，p = 0.015）。因此，盐水对比剂和彩色血流成像对于排除卵圆孔未闭的诊断均是必要的。
