Application of Transesophageal Echocardiography Combined with Contrast Transthoracic Echocardiography in Diagnosis of Cryptogenic Ischemic Stroke

doi:10.7517/issn.1674-0475.200413

Abstract

Abstract: A total of 147 patients with cryptogenic ischemic stroke (CIS) were selected for a retrospective study. Among them, there were 99 patients with patent foramen ovale (PFO) related CIS (PFO group) and 48 patients with non-PFO related CIS (non-PFO group). All patients underwent transesophageal echocardiography (TEE) and contrast transthoracic echocardiography (cTTE). The detection rate of cTTE and cTTE+TEE for PFO and right-to-left shunt (RLS) grade were compared, as well as their safety. And the score of paradoxical embolism (RoPE) scale, the inner diameter of PFO, the length of PFO were compared between the two groups. The receiver operating characteristic (ROC) curve and the area under the ROC (AUC) were used to analyze the diagnostic efficacy. The correlation between RoPE score, PFO inner diameter and RLS classification were also analyzed. The results showed that the 855 positive rate of PFO detected by cTTE+TEE (67.35%) was higher than that of cTTE (55.10%). The proportion of patients with RLS grade Ⅰ+Ⅱ+Ⅲ (64.63%) detected by cTTE+TEE was also higher than that of cTTE (53.06%). The highest AUC of RoPE score combined with the inner diameter of PFO in diagnosis of PFO-related CIS was 0.928, and RoPE score was positively correlated with inner diameter of PFO and RLS classification (P<0.05). In summary, cTTE combined with TEE can improve the detection rate of PFO and judge the degree of RLS collectly. RoPE score and inner diameter of PFO can be used for the diagnosis of PFO-RLS-related CIS.

Key words: transesophageal echocardiography, contrast transthoracic echocardiography, cryptogenic ischemic stroke, RoPE score, PFO inner diameter, ROC

DUAN Binghui, HUANG Lei, YIN Yuliang, XU Fangfang, LU Yuchen. Application of Transesophageal Echocardiography Combined with Contrast Transthoracic Echocardiography in Diagnosis of Cryptogenic Ischemic Stroke[J]. Imaging Science and Photochemistry, 2020, 38(5): 855-861.

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