摘要
右向左分流目前被认为与隐源性卒中密切相关,右向左分流分为心内分流及心外分流,在心内分流中卵圆孔未闭(patent foramen ovale,PFO)已经得到神经内科医生的广泛认识,但在心外分流中,由于肺动静脉畸形(pulmonary arteriovenous malformation,PAVM)发生率低,往往被忽视,但其卒中及复发的概率要远高于PFO。目前发泡试验已经广泛应用到右向左分流的筛查中,对于早期分流及三个心动周期内出现栓子的阳性患者,我们往往将其全部归为PFO,并且认为肺内右向左分流栓子出现的时间要长于在心内分流的时间。但事实上分流的时间并不存在某一绝对界值,单纯根据时间不能区分心内及心外分流,本文主要分析使用对比增强经颅多普勒超声(con‑trasted transranial Doppler sonography,c-TCD)检测PAVM所致右向左分流及其分流特点。
Currently it is believed that right-to-left shunt is closely associated with cryptogenic stroke.Right-to-left shunt is classified into intracardiac shunt and extracardiac shunt.As for intracardiac shunt,patent foramen ovale(PFO)has been widely recognized by neurologists,but as for extracardiac shunt,pulmonary arteriovenous malformation(PAVM)is often neglected due to its low incidence rate,but with significantly higher probabilities of stroke and recurrence than PFO.At present,the foaming test has been widely used in the screening for right-to-left shunt。The patients with positive emboli in early shunt and three cardiac cycles are often classified as PFO,and it is believed that the emboli caused by in‑trapulmonary right-to-left shunt tend to appear earlier than those caused by intracardiac shunt.In fact,there is no absolute limit for the time of shunt,and it is impossible to distinguish intracardiac shunt from extracardiac shunt based on such time alone.This article mainly analyzes the characteristics of right-to-left shunt caused by PAVM using contrast-enhanced tran‑scranial Doppler(c-TCD).
作者
雷淇松
张医芝
韩梦岩(综述)
贾革(审校)
LEI Qisong;ZHANG Yizhi;HAN Mengyan(Department of Neurology,Second Hos-pital,Jilin University,Changchun 130041,China)
出处
《中风与神经疾病杂志》
CAS
2024年第2期189-192,共4页
Journal of Apoplexy and Nervous Diseases
关键词
经颅多普勒超声
肺动静脉畸形
脑梗死
卵圆孔未闭
Transcranial Doppler
Pulmonary arteriovenous malformation
Cerebral infarction
Patent fora‑men ovale
