Li Xiong1, Yingting Zeng2, Tian Gan1, Feifei Yan1, Jiao Bai1, Yanbin Shi2, Xiaoyue Zhou3, Yu Wu4, Xiaochun Zhang5. 1. Department of Cardiovascular Ultrasound, Zhongnan Hospital, Wuhan University, 169 East Lake Road, Wuhan, 430071, China. 2. Department of Radiology, Zhongnan Hospital, Wuhan University, 169 East Lake Road, Wuhan, 430071, China. 3. Siemens Healthineers Ltd., Shanghai, 201218, China. 4. Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, 510623, China. 5. Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, 510623, China. zxcylxyr@163.com.
Abstract
PURPOSE: This study was undertaken to determine if coronary computed tomographic angiography (CCTA) can help to assess patent foramen ovale (PFO) with high accuracy and reproducibility when compared to transesophageal echocardiography (TEE). MATERIALS AND METHODS: In total, 75 suspected PFO cases (31 men, 44 women; mean age, 45 ± 9 years) were evaluated by coronary CTA and TEE. PFO tunnel length (TL) and the opening diameter of the left atrial entrance (ODLAE) and right atrial entrance (ODRAE), as well as contrast shunt (if present due to PFO), were measured by both modalities. RESULTS: PFO was detected in 68 patients with TEE. The sensitivity for the detection of PFO with CCTA was 85.3%; specificity, 71.4%; positive predictive value, 96.7%; and negative predictive value, 33.3%. Both modalities demonstrated good agreement in measuring TL and ODLAE of PFO. However, the ODRAE of TEE was different from that of CCTA (1.14 ± 0.4 mm and 1.45 ± 0.5 mm, respectively, p = 0.04). The intra-observer and inter-observer variability and agreement for TL, ODRAE, and ODLAE of PFO were excellent between the two measurements. CONCLUSION: CCTA provided a method for detection of PFO with high accuracy and reproducibility compared with TEE. Therefore, CCTA is a practical and efficient alternative to TEE for PFO diagnosis.
PURPOSE: This study was undertaken to determine if coronary computed tomographic angiography (CCTA) can help to assess patent foramen ovale (PFO) with high accuracy and reproducibility when compared to transesophageal echocardiography (TEE). MATERIALS AND METHODS: In total, 75 suspected PFO cases (31 men, 44 women; mean age, 45 ± 9 years) were evaluated by coronary CTA and TEE. PFO tunnel length (TL) and the opening diameter of the left atrial entrance (ODLAE) and right atrial entrance (ODRAE), as well as contrast shunt (if present due to PFO), were measured by both modalities. RESULTS: PFO was detected in 68 patients with TEE. The sensitivity for the detection of PFO with CCTA was 85.3%; specificity, 71.4%; positive predictive value, 96.7%; and negative predictive value, 33.3%. Both modalities demonstrated good agreement in measuring TL and ODLAE of PFO. However, the ODRAE of TEE was different from that of CCTA (1.14 ± 0.4 mm and 1.45 ± 0.5 mm, respectively, p = 0.04). The intra-observer and inter-observer variability and agreement for TL, ODRAE, and ODLAE of PFO were excellent between the two measurements. CONCLUSION: CCTA provided a method for detection of PFO with high accuracy and reproducibility compared with TEE. Therefore, CCTA is a practical and efficient alternative to TEE for PFO diagnosis.
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