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Contrast-enhanced transcranial Doppler for the detection of right-to-left shunt: A new provocation method with a syringe-modified Valsalva maneuver.
Deng, Jinfeng; Luo, Yan; Luo, Shijian; Zhan, Hongrui; Zhou, Feng; Li, Songbiao.
Afiliación
  • Deng J; Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Luo Y; Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Luo S; Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Zhan H; Department of Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Zhou F; Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
  • Li S; Cardiovascular Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Brain Behav ; 14(6): e3304, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38760914
ABSTRACT

BACKGROUND:

Contrast-enhanced transcranial Doppler (cTCD) study has been established as one of the most common investigations for detecting right-to-left shunt (RLS). Although the conventional Valsalva maneuver (c-VM) has been used to increase the sensitivity of cTCD for RLS, efforts are still needed to improve the detection rate further. We proposed a new provocation method with a syringe-modified Valsalva maneuver (sm-VM) during cTCD and compared the efficacy of this strategy with cTCD measured at resting and with the provocation of c-VM.

METHODS:

Consecutive patients with suspicion of RLS who underwent cTCD in our institution between September 27, 2021, and April 1, 2022, were included in this study. Examination of cTCD was performed separately at the resting state and provoked with c-VM and sm-VM. The overall proportion of patients with RLS and their distribution with different RLS grades were compared.

RESULTS:

A total of 389 patients (mean age 49.37 years, male 52.2%) were included in this study. The positive rate for RLS was significantly higher for cTCD detected with sm-VM than those detected at resting state and with c-VM (46.8% vs. 21.6% and 34.2%, all p < .05). Besides, cTCD detected with sm-VM was also associated with a higher proportion of patients with grade III RLS than those detected at resting state and with c-VM (11.3% vs. 1.8% and 0%, all p < .05).

CONCLUSIONS:

Compared to cTCD detected at resting state and with c-VM, cTCD with sm-VM could further increase the positive detection rate of RLS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Maniobra de Valsalva / Ultrasonografía Doppler Transcraneal Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Brain Behav Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Maniobra de Valsalva / Ultrasonografía Doppler Transcraneal Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Brain Behav Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos