Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study
BackgroundRight-to-left shunt (RLS) is associated with several conditions and causes morbidity. In this study, we aimed to evaluate the effectiveness of synchronous multimode ultrasonography in detecting RLS.MethodsWe prospectively enrolled 423 patients with high clinical suspicion of RLS and divide...
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1148846/full |
| _version_ | 1797799560521711616 |
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| author | Qingyang Yao Huahua Xiong Huahua Xiong Daxue Zhang Shuqun Ren Wenwei Qi Xia Zou Xia Zou Yingying Zhao Yingying Zhao Shanshan Huang Shanshan Huang Jing Wang Jing Wang Liming Cao Liming Cao |
| author_facet | Qingyang Yao Huahua Xiong Huahua Xiong Daxue Zhang Shuqun Ren Wenwei Qi Xia Zou Xia Zou Yingying Zhao Yingying Zhao Shanshan Huang Shanshan Huang Jing Wang Jing Wang Liming Cao Liming Cao |
| author_sort | Qingyang Yao |
| collection | DOAJ |
| description | BackgroundRight-to-left shunt (RLS) is associated with several conditions and causes morbidity. In this study, we aimed to evaluate the effectiveness of synchronous multimode ultrasonography in detecting RLS.MethodsWe prospectively enrolled 423 patients with high clinical suspicion of RLS and divided them into the contrast transcranial Doppler (cTCD) group and synchronous multimode ultrasound group, in which both cTCD and contrast transthoracic echocardiography (cTTE) were performed during the same process of contrast-enhanced ultrasound imaging. The simultaneous test results were compared with those of cTCD alone.ResultsThe positive rates of grade II (22.0%:10.0%) and III (12.7%:10.8%) shunts and the total positive rate (82.1748%) in the synchronous multimode ultrasound group were higher than those in the cTCD alone group. Among patients with RLS grade I in the synchronous multimode ultrasound group, 23 had RLS grade I in cTCD but grade 0 in synchronous cTTE, whereas four had grade I in cTCD but grade 0 in synchronous cTTE. Among patients with RLS grade II in the synchronous multimode ultrasound group, 28 had RLS grade I in cTCD but grade II in synchronous cTTE. Among patients with RLS grade III in the synchronous multimode ultrasound group, four had RLS grade I in cTCD but grade III in synchronous cTTE. Synchronous multimode ultrasound had a sensitivity of 87.5% and specificity of 60.6% in the patent foramen ovale (PFO) diagnosis. Binary logistic regression analyses showed that age (odds ratio [OR] = 1.041) and risk of paradoxical embolism score ≥ 7 (OR = 7.798) were risk factors for stroke recurrence, whereas antiplatelets (OR = 0.590) and PFO closure with antiplatelets (OR = 0.109) were protective factors.ConclusionSynchronous multimodal ultrasound significantly improves the detection rate and test efficiency, quantifies RLS more accurately, and reduces testing risks and medical costs. We conclude that synchronous multimodal ultrasound has significant potential for clinical applications. |
| first_indexed | 2024-03-13T04:20:45Z |
| format | Article |
| id | doaj.art-6871658b3f814fe1a9c84dca46e2ea83 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T04:20:45Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6871658b3f814fe1a9c84dca46e2ea832023-06-20T10:12:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-06-011410.3389/fneur.2023.11488461148846Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical studyQingyang Yao0Huahua Xiong1Huahua Xiong2Daxue Zhang3Shuqun Ren4Wenwei Qi5Xia Zou6Xia Zou7Yingying Zhao8Yingying Zhao9Shanshan Huang10Shanshan Huang11Jing Wang12Jing Wang13Liming Cao14Liming Cao15Department of Neurology, The First Hospital of Quanzhou Affliated to Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Ultrasound, Shenzhen Second People’s Hospital, Shenzhen, ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaSchool of Nursing, Anhui Medical University, Hefei, ChinaSchool of Nursing, Guangxi University of Chinese Medicine, Nanning, ChinaTianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Ultrasound, Shenzhen Second People’s Hospital, Shenzhen, ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaDepartment of Ultrasound, Shenzhen Second People’s Hospital, Shenzhen, ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaDepartment of Ultrasound, Shenzhen Second People’s Hospital, Shenzhen, ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaDepartment of Ultrasound, Shenzhen Second People’s Hospital, Shenzhen, ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaDepartment of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaCollege of Pharmacy, Changsha Medical University, Changsha, ChinaBackgroundRight-to-left shunt (RLS) is associated with several conditions and causes morbidity. In this study, we aimed to evaluate the effectiveness of synchronous multimode ultrasonography in detecting RLS.MethodsWe prospectively enrolled 423 patients with high clinical suspicion of RLS and divided them into the contrast transcranial Doppler (cTCD) group and synchronous multimode ultrasound group, in which both cTCD and contrast transthoracic echocardiography (cTTE) were performed during the same process of contrast-enhanced ultrasound imaging. The simultaneous test results were compared with those of cTCD alone.ResultsThe positive rates of grade II (22.0%:10.0%) and III (12.7%:10.8%) shunts and the total positive rate (82.1748%) in the synchronous multimode ultrasound group were higher than those in the cTCD alone group. Among patients with RLS grade I in the synchronous multimode ultrasound group, 23 had RLS grade I in cTCD but grade 0 in synchronous cTTE, whereas four had grade I in cTCD but grade 0 in synchronous cTTE. Among patients with RLS grade II in the synchronous multimode ultrasound group, 28 had RLS grade I in cTCD but grade II in synchronous cTTE. Among patients with RLS grade III in the synchronous multimode ultrasound group, four had RLS grade I in cTCD but grade III in synchronous cTTE. Synchronous multimode ultrasound had a sensitivity of 87.5% and specificity of 60.6% in the patent foramen ovale (PFO) diagnosis. Binary logistic regression analyses showed that age (odds ratio [OR] = 1.041) and risk of paradoxical embolism score ≥ 7 (OR = 7.798) were risk factors for stroke recurrence, whereas antiplatelets (OR = 0.590) and PFO closure with antiplatelets (OR = 0.109) were protective factors.ConclusionSynchronous multimodal ultrasound significantly improves the detection rate and test efficiency, quantifies RLS more accurately, and reduces testing risks and medical costs. We conclude that synchronous multimodal ultrasound has significant potential for clinical applications.https://www.frontiersin.org/articles/10.3389/fneur.2023.1148846/fullsynchronous testmultimode ultrasoundcontrast-transthoracic echocardiographycontrast-transcranial Dopplerright-to-left shunttest effect |
| spellingShingle | Qingyang Yao Huahua Xiong Huahua Xiong Daxue Zhang Shuqun Ren Wenwei Qi Xia Zou Xia Zou Yingying Zhao Yingying Zhao Shanshan Huang Shanshan Huang Jing Wang Jing Wang Liming Cao Liming Cao Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study Frontiers in Neurology synchronous test multimode ultrasound contrast-transthoracic echocardiography contrast-transcranial Doppler right-to-left shunt test effect |
| title | Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study |
| title_full | Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study |
| title_fullStr | Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study |
| title_full_unstemmed | Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study |
| title_short | Synchronous multimode ultrasound for assessing right-to-left shunt: a prospective clinical study |
| title_sort | synchronous multimode ultrasound for assessing right to left shunt a prospective clinical study |
| topic | synchronous test multimode ultrasound contrast-transthoracic echocardiography contrast-transcranial Doppler right-to-left shunt test effect |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1148846/full |
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