Validation of Transcranial Doppler Sonography in the Assessment of Patent Foramen Ovale

1995 ◽  
Vol 5 (3) ◽  
pp. 194-198 ◽  
Author(s):  
G. Paolo Anzola ◽  
E. Renaldini ◽  
M. Magoni ◽  
A. Costa ◽  
M. Cobelli ◽  
...  
2010 ◽  
Vol 63 (7-8) ◽  
pp. 445-449
Author(s):  
Zeljko Zivanovic ◽  
Svetlana Ruzicka-Kaloci ◽  
Aleksandar Jesic ◽  
Biljana Radovanovic ◽  
Aleksandra Lucic-Prokin ◽  
...  

A patent foramen ovale has been reported to be more frequently detected in cryptogenic stroke, with paradoxical embolism as the major pathogenetic mechanism. The standard procedure for the detection of a patent foramen ovale is transesophageal echo?cardiography. Transcranial Doppler sonography with bubble test is almost as reliable as transesophageal echocardiography. Seventeen patients with acute ischemic stroke and transient ischemic attacks hospitalized at the Department of Neurology in Novi Sad underwent examinations to detect a patent foramen ovale, which was found in 55.6% of patients with cryptogenic stroke. The average age of these patients was 30.6 years. Transcranial Doppler sonography showed 100% sensitivity and 100% specificity for the predicti?on of right-to-left shunts proven by transesophageal contrast echocardiography. Both positive and negative predictive values in our group of patients were 1. Transcranial Doppler with bubble test is a reliable method for the detection of a patent foramen ovale, with a high level of sensitivity and specificity which is comparable with transesophageal echocardiography. Moreover, it is cheaper and more comfortable than transesophageal echocardiography, and should be used routinely in neurological practice.


2018 ◽  
Vol 35 (2) ◽  
pp. 127-133
Author(s):  
Madison B. Stafford ◽  
Jennifer E. Bagley ◽  
Dora DiGiacinto

The correlation between cryptogenic stroke and patent foramen ovale is high in young patients. Currently, transesophageal echocardiography is the gold standard for detection. However, it is invasive and limits Valsalva maneuvers. This article reviews the diagnostic accuracy of the three modalities: transthoracic echocardiography, transesophageal echocardiography, and transcranial Doppler. The results suggest that transcranial Doppler sonography is an accurate, easily accessible procedure for detecting patent foramen ovale and should be considered an excellent alternative to transthoracic or transesophageal echocardiography. Transesophageal echocardiography is still necessary for patients who require treatment. The combination of transcranial Doppler and transesophageal echocardiography provides the highest level of information regarding the complete diagnosis of patent foramen ovales.


2021 ◽  
Author(s):  
Zhiming Li ◽  
Shunli Liu ◽  
Tingfei Yan ◽  
Yabin Hu ◽  
Chuanyu Zhang ◽  
...  

Abstract Purpose: To investigate the clinical feasibility of diagnosing and classifying patent foramen ovale (PFO) in patients with cerebral disorders by cardiac cine MRI (CCMRI) without contrast.Materials and Methods: Forty-four patients (24 males and 20 females; mean age, 41.3 years; range, 21–64 years) with cerebral disorders underwent contrast transcranial Doppler sonography (cTCD) and non-enhanced CCMRI examinations between October 2019 and March 2020. CCMRI was performed with a 3.0T magnetic resonance (MR) scanner using the OBL FIESTA CINE 4CH sequence. The scanning direction was perpendicular to the interatrial septum (IAS). The obtained MR images were analyzed by AW station 4.4. Pseudo-color coding was performed based on the different phases. The blood shunt condition was observed and recorded, noting the PFO length and width and whether it was complicated by IAS aneurysm or secondary septum thickening.Results: Thirty-nine of the 44 patients with cerebral disorders were confirmed to have right-to-left shunt by cTCD, and 37 of them were diagnosed with PFO by CCMRI. Two of the five remaining patients were also diagnosed with PFO by CCMRI. Compared with cTCD as a standard, CCMRI assessment resulted in the following: sensitivity, 94.9%; specificity, 60.0%; accuracy, 90.9%; positive predictive value, 94.9%; negative predictive value, 60.0%; area under the curve, 0.774. Using pseudo-color coding, a right-to-left color jet was observed in 34 patients, and a two-way shunt was found in five. IAS aneurysm and secondary septum thickening were found in five and three patients (11.4% and 6.8%), respectively. The maximum PFO diameters ranged from 1.7 to 16.8 mm, and the mean diameter was 5.4 ± 3.4 mm.Conclusion: The noninvasive CCMRI without contrast proved an excellent method for PFO identification, evaluation, and classification, with high sensibility (92.85%) and concordance (90.9%) compared to cTCD.


1996 ◽  
Vol XXVIII (3-4) ◽  
pp. 23-25
Author(s):  
М. Salaschek ◽  
R. Winkel

In patients with cerebral ischemia of unknown origin, paradoxical embolism must be considered as one of the possible causes, if there is an abnormal right-to- left shunt. The most likely site of transmission is a persisting patent foramen ovale (PFO), which is found in approximately 30% of adult persons in autopsy studies. Using transcranial Doppler sonography (TCD) and an agitated saline solution as an inexpensive and readily available contrast medium, probably all clinically important right-to-left shunts can be detected. In our department we examined 215 patients within the last 5 years, 30% of which had an abnormal right-to-left shunt with insignificant difference between 10 and 69 years of age.


Cephalalgia ◽  
2006 ◽  
Vol 26 (8) ◽  
pp. 934-939 ◽  
Author(s):  
FJ Carod-Artal ◽  
L da Silveira Ribeiro ◽  
H Braga ◽  
W Kummer ◽  
HM Mesquita ◽  
...  

The aim of this study was to investigate the prevalence of patent foramen ovale (PFO) in a consecutive unselected cohort of migraine patients (with and without aura) and compare it with a group of ischaemic young and elderly stroke patients. One hundred and forty-one migraine patients were compared with 330 stroke patients (130 young patients; 200 elderly patients) selected from our hospital stroke data bank. PFO was assessed with transcranial Doppler sonography with i.v. injection of agitated saline. The prevalence of PFO was 51.7± in migraine with aura (MA) patients, 33.7± in migraine without aura (MoA) patients, 33.8± in young stroke patients and 20.5± in elderly stroke patients ( P < 0.001). The prevalence of PFO in cryptogenic stroke in young and elderly stroke patients was, respectively, 41.1± and 25± ( P = 0.04). The difference between MA and MoA patients was significant (odds ratio = 2.1). The prevalence of PFO in MA patients is higher than in MoA patients and in young cryptogenic stroke patients.


1994 ◽  
Vol 33 (06) ◽  
pp. 239-243 ◽  
Author(s):  
F. Grünwald ◽  
P. Barzó ◽  
E. Ambrus ◽  
C. Menzel ◽  
A. Schomburg ◽  
...  

ZusammenfassungBei 29 Patienten (3 Kontrollpersonen, 26 Patienten mit zerebrovaskulärer Erkrankung) wurde prospektiv die Hirn-SPECT mit 99mTC-HMPAO und bei 20 Patienten (3 Kontrollpersonen, 17 Patienten mit ZVK) die transkranielle Dopplersonographie (TCD) vor und nach i. v. Gabe von Azetazolamid durchgeführt. Die Sensitivität der Hirn-SPECT erhöhte sich mit Azetazolamid von 62% auf 77%. Bei Patienten mit reversiblem neurologischem Defizit wurde eine Verbesserung von 50% auf 71 %, bei Patienten mit persistierendem Defizit von 75% auf 83% beobachtet. Die Ergebnisse der Hirn-SPECT und der TCD stimmten in der Beurteilung der zerebro-vaskulären Reservekapazität in 91% der Hemisphären überein. Die Korrelation zwischen den beiden Methoden war statistisch signifikant.


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