Application of Cerebrocardiac Contrast-Enhanced Ultrasound in the Diagnosis of Patent Foramen Ovale

doi:10.3969/j.issn.1673-5765.2025.11.007

Abstract

Abstract: This article systematically reviews the application status, technical characteristics, existing challenges, and future prospects of cerebrocardiac contrast-enhanced ultrasound in the precision diagnosis of patent foramen ovale (PFO). Compared with single-modality contrast-enhanced ultrasound, cerebrocardiac contrast-enhanced ultrasound integrates the advantages of contrast-enhanced transcranial Doppler, contrast-enhanced transthoracic echocardiography, and contrast-enhanced transesophageal echocardiography, enabling “structural-functional” dual-dimensional assessment, significantly improving the detection rate and diagnostic accuracy of PFO. Among them, the synchronous cerebrocardiac contrast-enhanced ultrasound allows single-contrast injection with dual-modality assessment, thereby optimizing the diagnosis and treatment process and reducing costs. The asynchronous cerebrocardiac contrast-enhanced ultrasound can provide key anatomical and functional evidence for the selection of indications for PFO closure, determination of device specifications, and prediction of stroke risk. This article also discusses the challenges faced by cerebrocardiac contrast-enhanced ultrasound, such as strong operator dependence and non-unified standards, and prospects future development directions including artificial intelligence empowerment, equipment innovation, and consensus formulation, aiming to provide theoretical basis and clinical practical guidance for promoting precision diagnosis and treatment of PFO.

Key words: Patent foramen ovale; Right to left shunt; Contrast-enhanced transcranial Doppler; Contrast-enhanced transthoracic echocardiography; Multimodal ultrasound

摘要： 本文系统综述脑心联合超声造影在卵圆孔未闭（patent foramen ovale，PFO）精准诊断中的应用现状、技术特点、面临的挑战及未来展望。相较于单一模态超声造影，脑心联合超声造影通过整合对比增强TCD、对比增强经胸超声心动图及对比增强经食管超声心动图的优势，可实现结构-功能双维度评估，提升PFO检出率与诊断准确性。其中，同步脑心联合超声造影可实现单次造影、双模态评估，从而优化诊疗流程并降低成本；非同步脑心联合超声造影则能为PFO封堵术的适应证选择、器械规格确定及卒中风险预测提供关键解剖与功能学依据。本文探讨了脑心联合超声造影面临的操作者依赖性强、标准不统一等挑战，并展望了人工智能赋能、设备革新及共识制定等未来发展方向，为推动PFO的精准化诊疗提供理论依据与临床实践指导。

关键词: 卵圆孔未闭; 右向左分流; 对比增强经颅多普勒超声; 对比增强经胸超声心动图; 多模态超声

CLC Number:

HUANG Xuming, GAN Qingyue, CAO Liming. Application of Cerebrocardiac Contrast-Enhanced Ultrasound in the Diagnosis of Patent Foramen Ovale[J]. Chinese Journal of Stroke, 2025, 20(11): 1387-1393.

黄旭明, 甘清月, 曹黎明. 脑心联合超声造影诊断卵圆孔未闭的应用[J]. 中国卒中杂志, 2025, 20(11): 1387-1393.

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