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Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography

 Young Jin Kim  ;  Jin Hur  ;  Chi-Young Shim  ;  Hye-Jeong Lee  ;  Jong-Won Ha  ;  Kyu Ok Choe  ;  Ji Hoe Heo  ;  Eui-Young Choi  ;  Byoung Wook Choi 
 RADIOLOGY, Vol.250(1) : 61-67, 2009 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction/diagnosis ; Cerebral Infarction/etiology ; Contrast Media/administration & dosage ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal* ; Electrocardiography ; Extravasation of Diagnostic and Therapeutic Materials/diagnosis ; Feasibility Studies ; Female ; Foramen Ovale, Patent/diagnosis* ; Humans ; Iopamidol ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Sodium Chloride ; Tomography, Spiral Computed*
PURPOSE: To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. RESULTS: A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. CONCLUSION: A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Choe, Kyu Ok(최규옥)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
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