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The role of cardiac CT throughout the full cardiac cycle in diagnosing patent foramen ovale in patients with acute stroke

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Author(s)
Seonhwa LeeIn-Cheol KimYoung Dae KimHyo Suk NamSo yeon KimSeon mi ChoiHyuk-Jae Chang
Keimyung Author(s)
Kim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Eur Radiol
Issued Date
2021
Volume
31
Issue
12
Keyword
Foramen ovale patentTomography, X-ray computedEchocardiography, transesophageal
Abstract
Objectives:
We explored the hypothesis that the diagnostic performance of cardiac computed tomography (CT) throughout the full cardiac cycle would be superior to single-phase CT and comparable to transesophageal echocardiography (TEE) in diagnosing patent foramen ovale (PFO).

Methods and results:
From May 2011 to April 2015, 978 patients with stroke were diagnosed with PFO by TEE. In patients with stroke, cardiac CT was performed if the patients had more than two cardiovascular risk factors. We prospectively enrolled 70 patients with an indication for cardiac CT. Cardiac CT images were reconstructed at 10% increments of the R-R interval. The sensitivity of cardiac CT throughout the full cardiac cycle in diagnosing PFO was compared to that for TEE and single-phase cardiac CT. To evaluate the specificity of cardiac CT, we analyzed patients without PFO confirmed by TEE who underwent cardiac CT within 1 month of pre-cardiac surgery. Sixty-six patients with cardiac CT and TEE were included in the final analysis. Throughout the full cardiac cycle, cardiac CT had a sensitivity of 89.4% and a specificity of 92.3% in diagnosing PFO, compared to TEE as a reference. PFO was primarily detected in the 60% and 70% intervals in 10-phase reconstructed images. The sensitivity of PFO diagnosis with cardiac CT was 81.8% when analyzing both the 60% and 70% intervals instead of the full cardiac cycle.

Conclusion:
Cardiac CT throughout the full cardiac cycle outperforms single-phase cardiac CT in detecting PFO. Cardiac CT can be used as an alternative method to TEE for detecting PFO in stroke patients.
Keimyung Author(s)(Kor)
김인철
Publisher
School of Medicine (의과대학)
Citation
Seonhwa Lee et al. (2021). The role of cardiac CT throughout the full cardiac cycle in diagnosing patent foramen ovale in patients with acute stroke. Eur Radiol, 31(12), 8983–8990. doi: 10.1007/s00330-021-08037-y
Type
Article
ISSN
1432-1084
Source
https://link.springer.com/article/10.1007%2Fs00330-021-08037-y
DOI
10.1007/s00330-021-08037-y
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43795
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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