Analysis Of Clinic Features Of 60 Cryptogenic Stroke Patients With Positive Contrast-enhanced Transcranial Doppler (c-TCD)

Objective 1.To investigate the clinical diagnostic value of contrast-enhanced transcranial Doppler(cTCD)in patients with cryptogenic stroke.2.To study the relationship between PFO-RLS and cryptogenic stroke(CS).3.To study the related risk factors and the imaging features of CS.Methods Selected from the Department of Neurology,the First Affiliated Hospital of Jiamusi University,from October 2017 to October 2018,a total of 60 patients who were determined by means of contrast-enhanced transcranial Doppler(cTCD)and transesophageal echocardiogtaphy(TEE).The clinical diagnosis was a cryptogenic stroke with PFO.60 patients with ischemic stroke without PFO at the same time were randomly selected as the control group.The differences in imaging features and risk factors between patients with PFO(+)and PFO(-)were compared.To compare the specificity and sensitivity of cTCD and TEE in the diagnosis of PFO-RLS in cryptogenic stroke,and to analyze the correlation between RLS and the etiology of CS patients.Results 1.cTCD has a sensitivity of 96.6%and a specificity of 96.8%.It can be widely used as an important screening for cryptogenic stroke patients with right-to-left shunt(RLS).2.The average age of PFO(+)CS group was 46.98±6.30,the average age of PFO(-)IS group was51.35±9.19,P=0.001,the age difference has statistically significant,and the age of PFO(+)CS group was smaller.In terms of gender,there was no statistically significant difference between the two groups(P=0.439),The risk factors of cerebrovascular disease were statistically significant(P<0.05),and the proportion of risk factors in PFO(+)CS group was low.3.There was a statistically significant difference in the number of infarcts between the PFO(+)CS group and the PFO(-)IS(p<0.05).Most of the lesions in the PFO(+)CS group were single-shot.There was a statistically significant difference in the imaging findings between the two groups(p<0.05).PFO combined with cryptogenic stroke was more likely to occur in the anterior circulation.4.Compared with the control group,the positive rate of RLS in the CS group was56.7%and 25.0%in the control group.The difference between the two groups was statistically significant(?~2=12.452,p<0.001).High incidence of PFO-RLS positive in patients with cryptogenic stroke.Conclusions 1.cTCD has high sensitivity and specificity for the diagnosis of PFO in CS patients,It can be used as an important means for screening CS patients with PFO-RLS.2.The proportion of cerebrovascular risk factors in patients with PFO(+)CS is low and the age of onset was smaller.3.Infarcts in patients with PFO(+)CS are mostly single and prone to occur in the anterior circulation.4.PFO-RLS is the main cause of Cryptogenic Stroke.