ArticleScientific reports2025
Three-dimensional agitated saline contrast transesophageal echocardiography for the diagnosis of patent foramen ovale.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Correlation Between Interatrial Septal In Situ Thrombus and Stroke Evaluated by Transesophageal Echocardiography.Reviews in cardiovascular medicine · 2026Article
- Quantitative assessment and clinical value of right-to-left shunt in patent foramen ovale using three-dimensional transesophageal echocardiography combined with right-heart contrast: a prospective study.Cardiovascular diagnosis and therapy · 2026Article
- High-density contrast echocardiography for patent foramen ovale assessment: sensitivity and relationship with invasively measured shunt severity and atrial septum morphology.Echo research and practice · 2026Article
- Unexplained Positional Hypoxemia in an Elderly Patient: A Case of Platypnea-Orthodeoxia Syndrome.Cureus · 2026Article
- Case Report: Multimodal ultrasound diagnosis of traumatic right coronary sinus rupture combined with atrial septal tears.Frontiers in medicine · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
Patent foramen ovale (PFO) is a three-dimensional (3D) and dynamic structure, making diagnosis challenging with 2D imaging. We aimed to develop a practical 3D agitated saline contrast (ASC) transesophageal echocardiography (TEE) protocol, assess its feasibility, and evaluate its diagnostic implications in ischemic stroke patients. In 158 ischemic stroke patients (52 women; age: 63.6 ± 14.0 years) undergoing TEE to assess embolic sources, 2D and 3D ASC tests were performed using the EPIQ CVx ultrasound system (Philips Medical Systems, Andover, MA) with a 2-8 MHz transesophageal matrix array transducer (X8-2t). Patients were categorized into four groups: no shunt, possible PFO, definite PFO, and intrapulmonary shunt. The practical 3D ASC protocol included bicaval (90°-120°) and short-axis (40°-70°) views at the mid-esophageal level, visualizing the left upper pulmonary vein and interatrial septum. Image acquisition was feasible in 150 patients (94.9%). By applying the 3D ASC protocol, 32 patients (21.3%) were reclassified into another group. Definite PFO cases increased from 20 (13.3%) to 35 (23.3%). The 3D ASC TEE protocol is feasible and improves the accuracy of PFO diagnosis in ischemic stroke patients, offering added value over 2D TEE.
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