색전성 뇌졸중의 선별진단을 위한 경흉부심초음파의 유용성

Abstract

Background and Objective : We examined whether patients suffering from suspicious embolic strole may be selected for transeophageal echocardiography (TEE) on the basis of abnormal transthoracic echocardiographic (TTE) findings. Methods : We performed TTE and TEE on 63 patients after suspected embolic stroke. Patients were classified into group A if they were in sinus rhythm and had a normal TTE, and group B consisted of all other patients. Abnormal TEE findings such as left ateial spontaneous contrast, left atrial thrombus. complex aortic atheroma, and interatrial septal anomalies were correlated with clinical and abnormal TTE results. Results : Abnormal TEE findings were in 30 patients (48%) : left atrial spontaneous contrast in 12 patients (19%), left atrial thrombus in 1 patient (2%), complex aortic atheroma in 10 patients (16%) and interatrial septal anomalies in 7 patients(11%). In group A (n=17), none had left atrial spontaneous contrast, left atrial thrombus, and interatrial septal anomalies, only 2 patients(7%) had complex atheroma. In group B (n=36), 12 patients(33%) had left atrial spontaneous contrast, 8 patients (22%) had aortic atheroma, 7 patients (19%) had interatrial septal anomalies and 1 patient(3%) had left atrial thrombus. There were no significant correlations between age and abnormal TEE findings. Multivariate analysis identified an abnormal TTE to be independent predictors of TEE findings of left atrial spontaneous contrast and interatrial anomalies. Conclusion : TTE is sensitive and noninvasive screening tool in patients with suspected embolic stroke.