Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Contrast transcranial Doppler ultrasound in the detection of right-to-leftshunts - Comparison of different procedures and different contrast agents
Autore:
Droste, DW; Kriete, JU; Stypmann, J; Castrucci, M; Wichter, T; Tietje, R; Weltermann, B; Young, P; Ringelstein, EB;
Indirizzi:
Univ Munster, Neurol Klin & Poliklin, Dept Neurol, D-48129 Munster, Germany Univ Munster Munster Germany D-48129 pt Neurol, D-48129 Munster, Germany Univ Munster, Dept Cardiol & Angiol, D-4400 Munster, Germany Univ MunsterMunster Germany D-4400 ol & Angiol, D-4400 Munster, Germany Univ Munster, Inst Arteriosclerosis Res, D-4400 Munster, Germany Univ Munster Munster Germany D-4400 lerosis Res, D-4400 Munster, Germany
Titolo Testata:
STROKE
fascicolo: 9, volume: 30, anno: 1999,
pagine: 1827 - 1832
SICI:
0039-2499(199909)30:9<1827:CTDUIT>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
PATENT FORAMEN OVALE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; VALSALVA MANEUVER; STROKE PATIENTS; SONOGRAPHY; EMBOLISM; TCD;
Keywords:
cerebrovascular disorders; cerebral embolism; foramen ovale, patent; ultrasonography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Droste, DW Univ Munster, Neurol Klin & Poliklin, Dept Neurol, Albert Schweitzer Str 33, D-48129 Munster, Germany Univ Munster Albert Schweitzer Str 33 Munster Germany D-48129
Citazione:
D.W. Droste et al., "Contrast transcranial Doppler ultrasound in the detection of right-to-leftshunts - Comparison of different procedures and different contrast agents", STROKE, 30(9), 1999, pp. 1827-1832

Abstract

Background and Purpose-Cardiac right-to-left shunts can be identified by transesophageal echocardiography (TEE) and by transcranial Doppler ultrasound (TCD) with the use of different contrast agents and different provocationprocedures. Currently, data on an appropriate time window for the appearance of contrast bubbles in the TCD recording after the injection of the contrast medium and the comparison of different provocation maneuvers to increase right-to-left shunting are insufficient. Methods-Forty-six patients were investigated by both TEE and bilateral TCDof the middle cerebral artery. The following protocol with 6 injection modes was applied in a randomized way: (1) injection of 10 mi, of agitated saline without Valsalva maneuver, (2) injection of 10 mt of agitated saline with Valsalva maneuver, (3) injection of 10 mt of a commercial galactose-based contrast agent (Echovist) without Valsalva maneuver, (4) injection of 10 mi, of Echovist with Valsalva maneuver, (5) injection of 10 mt of Echovist with standardized Valsalva maneuver, and (6) injection of 10 mi, of Echovist with coughing. Results-In 20 patients, a right-to-left shunt was demonstrated by TEE and contrast TCD (shunt-positive). Sixteen patients were negative in both investigations, no patient was positive on TEE and negative on TCD, and 10 patients were only positive on at least 1 TCD investigation but negative during TEE. The amount of microbubbles detected in the various tests decreased in the following order: Echovist and Valsalva maneuver, Echovist with coughing, Echovist and standardized Valsalva maneuver, saline with Valsalva maneuver, Echovist, and saline. With a time window of 20 to 25 seconds for the bubbles to appear in the TCD recording and with a sequence of first Echovist and Valsalva maneuver and then Echovist with coughing, all shunts were reliably identified with a specificity of 65% compared with TEE as the traditional gold standard, The time of first microbubble appearance was not helpful to distinguish between shunts detected on TEE and other shunts. Conclusions-TCD performed twice with 2 provocation maneuvers using Echovist is a sensitive method to identify cardiac right-to-left shunts also identified by TEE.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 12:31:58