Document Detail


Pitfalls in diagnosing PFO: characteristics of false-negative contrast injections during transesophageal echocardiography in patients with patent foramen ovales.
MedLine Citation:
PMID:  20850947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Contrast injections during transesophageal echocardiography for patent foramen ovale (PFO) detection may be false negative. The characteristics of false-negative injections were studied retrospectively.
METHODS: Contrast transesophageal echocardiography was analyzed for the presence or absence of two characteristics: leftward bulging of the interatrial septum and dense contrast filling of the region of the right atrium adjacent to the interatrial septum.
RESULTS: Two hundred forty-seven injections were administered to 14 patients with PFOs, and 130 (53%) were false negative. The absence of either characteristic during a single injection resulted in low sensitivity for PFO detection of 7%. When the two characteristics were present at the same time, the sensitivity for PFO detection after a single injection was as high as 95%.
CONCLUSIONS: The simultaneous presence of both leftward bulging of the interatrial septum and dense contrast filling of the region in the right atrium, adjacent to the interatrial septum, is a prerequisite for PFO detection, and if either characteristic is missing, the injection is inconclusive.
Authors:
Magnus C Johansson; Peter Eriksson; Cecilia Wallentin Guron; Mikael Dellborg
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-20
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  23     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2011-02-17     Revised Date:  2011-03-28    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1136-42     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Emergency and Cardiovascular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. magnus.c.johansson@vgregion.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Cohort Studies
Contrast Media / diagnostic use*
Echocardiography, Transesophageal / adverse effects,  methods*
False Negative Reactions
Female
Foramen Ovale, Patent / ultrasonography*
Humans
Image Enhancement*
Injections, Intravenous
Male
Middle Aged
Polygeline / diagnostic use*
Reference Values
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Contrast Media; 9015-56-9/Polygeline
Comments/Corrections
Comment In:
J Am Soc Echocardiogr. 2011 Mar;24(3):348; author reply 348-9   [PMID:  21227648 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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