Optimized transcranial Doppler technique for the diagnosis of cardiac right-to-left shunts
Transcranial Doppler sonography (TCD) is a simple method to detect a right-to-left cardiac shunt, although standardized procedures do not exist. In this study 69 patients were tested according to predetermined criteria and procedures (cluster of > 10 microbubbles, duration between injection in the cubital vein and detection in the middle cerebral artery [MCA] < or = 10 sec). Agitated saline solution was compared to oxypolygelatine, a plasma volume expander, as contrast media. Valsalva's maneuver and coughing were used to provoke right-to-left cardiac shunting, detected by TCD, transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Oxypolygelatine caused a significantly higher number of microbubbles in the right atrium and MCA than did the saline solution, leading to a greater diagnostic reliability of TCD (paired t test, p < 0.001). Coughing did not provoke right-to-left cardiac shunts (x2 analysis, p < 0.001). The technique used for carrying out Valsalva's maneuver was important for the detection of right-to-left cardiac shunts. Twenty-five right-to-left shunts were diagnosed with TCD and 18 with TTE (36 vs 26%; x2 analysis, p = 0.1). The findings indicate that TCD when properly done is highly sensitive and specific for the diagnosis of right-to-left cardiac shunts.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1997 |
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| Erschienen: |
1997 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Journal of neuroimaging : official journal of the American Society of Neuroimaging - 7(1997), 3 vom: 06. Juli, Seite 159-63 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Albert, A [VerfasserIn] |
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| Themen: |
451W47IQ8X |
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| Anmerkungen: |
Date Completed 15.08.1997 Date Revised 02.11.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM091917085 |
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| 100 | 1 | |a Albert, A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Optimized transcranial Doppler technique for the diagnosis of cardiac right-to-left shunts |
| 264 | 1 | |c 1997 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 15.08.1997 | ||
| 500 | |a Date Revised 02.11.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Transcranial Doppler sonography (TCD) is a simple method to detect a right-to-left cardiac shunt, although standardized procedures do not exist. In this study 69 patients were tested according to predetermined criteria and procedures (cluster of > 10 microbubbles, duration between injection in the cubital vein and detection in the middle cerebral artery [MCA] < or = 10 sec). Agitated saline solution was compared to oxypolygelatine, a plasma volume expander, as contrast media. Valsalva's maneuver and coughing were used to provoke right-to-left cardiac shunting, detected by TCD, transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Oxypolygelatine caused a significantly higher number of microbubbles in the right atrium and MCA than did the saline solution, leading to a greater diagnostic reliability of TCD (paired t test, p < 0.001). Coughing did not provoke right-to-left cardiac shunts (x2 analysis, p < 0.001). The technique used for carrying out Valsalva's maneuver was important for the detection of right-to-left cardiac shunts. Twenty-five right-to-left shunts were diagnosed with TCD and 18 with TTE (36 vs 26%; x2 analysis, p = 0.1). The findings indicate that TCD when properly done is highly sensitive and specific for the diagnosis of right-to-left cardiac shunts | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Müller, H R |e verfasserin |4 aut | |
| 700 | 1 | |a Hetzel, A |e verfasserin |4 aut | |
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