Detection of Patent Foramen Ovale: Transcranial Doppler and Echocardiography Are Not Equivalent to Define a Large Shunt

IF 1.3 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2026-10-06 Epub Date: 2026-05-27 DOI:10.1002/jcu.70278

Thomas Codant, Pauline Renou, Georgios Papaioannou, Jean-Benoît Thambo, Carine Boulon, Damien Barcat, Joël Constans, Loubna Dari

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引用次数: 0

Abstract

Background

The decision to close patent foramen ovale (PFO) depends on the size of PFO, the coexistence of interatrial septum aneurysm, and the importance of right-to-left shunt assessed by the number of bubbles on transcranial Doppler (TCD) and echocardiography after saline or glucose injection. The interventional threshold for the number of bubbles is considered to be the same for trans-thoracic and trans-esophageal echocardiography (TTE and TEE) and TCD. Our objective was to study whether the same thresholds can be used for TCD and echocardiography.

Patients and Methods

In this comparative, observational study, we modeled a linear relationship between the number of bubbles on TCD and echocardiography, which suggests a different threshold between TCD and TTE/TEE.

Results

We found a systematic difference between TTE/TEE and TCD for the number of bubbles in the same patient. From linear regression, we found the following equation: TCD_Estimate = (7.2 (95% CI: −2.36–16.8) + (2.67 (95% CI: 1.85–3.49, p < 0.001)) × TTE/TEE).

Conclusion

Different thresholds for the decision to close a PFO should be used for both techniques: 20 bubbles for echocardiography and 60 bubbles for TCD.

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卵圆孔未闭的检测：经颅多普勒和超声心动图不等同于确定大分流。

背景：决定关闭卵圆孔未闭（PFO）取决于PFO的大小，房间隔动脉瘤的存在，以及通过经颅多普勒（TCD）和生理盐水或葡萄糖注射后超声心动图的气泡数量来评估右至左分流的重要性。经胸和经食管超声心动图（TTE和TEE）和TCD的介入阈值被认为是相同的。我们的目的是研究相同的阈值是否可以用于TCD和超声心动图。患者和方法：在这项比较观察性研究中，我们模拟了TCD和超声心动图上气泡数量之间的线性关系，这表明TCD和TTE/TEE之间存在不同的阈值。结果：我们发现TTE/TEE和TCD在同一患者的气泡数量上存在系统差异。从线性回归中，我们发现了以下方程：tcdestination = (7.2 (95% CI: -2.36-16.8) + (2.67) （95% CI: 1.85-3.49, p）结论：两种技术应该使用不同的阈值来决定关闭PFO：超声心动图20个气泡，TCD 60个气泡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.