The Value Of CTCD In Assessing Patent Foreman Ovale In Young And Middle Aged Cryptogenic Stroke Patients

Objective:To evaluate the contrast-enhanced transcranial Doppler(cTCD) on the diagnosis patent foramen ovale(PFO) in young middle aged cryptogenic stroke patients, and to describe the imaging features of cryptogenic stoke due to PFO. Methods:We retrospectively investigated consecutive patients who were suspected to be cryptogenic stoke and having PFO admitted to one stroke center in this observational study. PFO was determined by means of cTCD and transesophageal echocardiography(TEE). From Jan.2014 to Jan. 2016,we recruited 49 adult patients with meeting the requirements,PFO was positive in 18 patients who was taken as group of A by both cTCD and TEE. PFO was negative in 29 patients by both cTCD and TEE.Two of these patients, PFO was positive by cTCD and negative by TEE.The group A and the group B were divided into 2 groups according to the number of cerebrel infarction in MRI, and divided into 4 groups according to the position of cerebrel infarction in MRI. Results:we thought TEE as “golden standard”. The sensitivity of diagnosing PFO was 100%,the specificity was 93.1%. From the point of the number, The comparison of the group of A and B was significant different. Cerebrel infarction were more frequent in posterior circuation and The percentage of multipe infarction in B group was less than group B(P<0.05). Conclusion:TCD with agitate saline contrast is sensitive in detecting a patent forman ovale,it may be an effective screening technique for detecting the pathogency of cryptogenic stroke.the imaging features of MRI might provide further information to guide clinical decisions.