缺血性脑血管病患者卵圆孔未闭多模态影像学诊断的研究进展

doi:10.3877/cma.j.issn.1673-9248.2026.01.015

隐源性脑卒中患者数量占缺血性脑卒中患者数量的30%以上，其中近半数与卵圆孔未闭（PFO）密切相关，故而对PFO进行精确诊断非常关键。目前，常用的超声检查方法包括经食管超声心动图（TEE）、增强经胸超声心动图（c-TTE）和增强经颅多普勒超声（c-TCD），但上述方法各有优劣性，即使被作为诊断金标准的TEE也存在半侵入性及部分患者不能充分完成Valsalva动作的局限性。近年来，随着无创性冠状动脉CT血管成像（CCTA）技术广泛应用，其在诊断PFO的优势值得关注。特别是，联合应用上述检测方法的多模态影像学诊断有望提升PFO诊断的精确性，但在临床上还未受到重视。因此，本文将围绕相关研究进展进行综述，以期促进临床医师对PFO诊断新方法及多模态影像学诊断方式的认识及实际应用。

关键词: 卵圆孔未闭, 缺血性脑血管病, CT血管成像, 超声检测, 多模态影像

Cryptogenic stroke constitutes over 30% of ischemic strokes, with patent foramen ovale (PFO) being identified as a significant etiological factor in nearly half of these cases. Consequently, accurate PFO diagnosis is clinically crucial. Established ultrasonic diagnostic techniques include transesophageal echocardiography (TEE), contrast-enhanced transthoracic echocardiography (c-TTE), and contrast-enhanced transcranial Doppler (c-TCD). Although TEE is the current reference standard, it is semi-invasive and often limited by inadequate Valsalva maneuver performance. Recently, the growing use of non-invasive coronary CT angiography (CCTA) has highlighted its potential for PFO diagnosis. In particular, the multimodal imaging that combines these diagnostic techniques holds promise for improving the accuracy of PFO detection, yet this approach has not received adequate attention in clinical practice. This article reviews pertinent research progress to enhance clinicians' understanding and application of innovative PFO diagnostic methods and multimodal imaging.

Key words: Patent foramen ovale, Ischemic cerebrovascular disease, CT angiography, Ultrasonography, Multimodal imaging

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Research progress on multimodal imaging for diagnosing patent foramen ovale in patients with ischemic cerebrovascular disease

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Research progress on multimodal imaging for diagnosing patent foramen ovale in patients with ischemic cerebrovascular disease