ArticleQuantitative imaging in medicine and surgery2026
Incremental value of characteristics of right-to-left shunt in patients with migraine and cryptogenic stroke via multi-modal echocardiography.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Quantitative Analysis of Pulmonary Right-to-Left Shunts and Patent Foramen Ovale via Agitated Saline Contrast Transesophageal Echocardiography: Associations With Migraine, Cryptogenic Stroke, and Transient Ischemic Attack.Echocardiography (Mount Kisco, N.Y.) · 2026Article
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7 authors.
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Abstract
Background: Right-to-left shunt (RLS) is closely associated with migraine and cryptogenic stroke (CS), but single diagnostic techniques have limitations in accurately identifying RLS. This study aimed to evaluate the incremental value of characteristics of RLS in patients with migraine and CS via multi-modal echocardiography and explore independent risk factors between patients with migraine and CS. Methods: A retrospective study enrolled 455 RLS patients (281 with migraine, 174 with CS) with diagnosis of migraine and CS between May 2022 and July 2024. Contrast-enhanced transcranial Doppler (c-TCD) and/or contrast-enhanced transthoracic echocardiography (c-TTE) were performed to screen RLS, subsequently contrast-enhanced transesophageal echocardiography (c-TEE) combined with real-time three-dimensional (RT-3D) volume imaging examination were followed. RLS was semi-quantitatively graded as I grade (1-10 microbubbles/frame), II grade (11-30 microbubbles/frame), or III grade (>30 microbubbles/frame or left atrial filling). The size and echo intensity of microbubbles were defined by comparison with the microbubbles in the right heart. The χ Results: Compared with TEE, c-TEE and RT-3D c-TEE examination could improve the detection rate of RLS and identify RLS origination, including patent foramen ovale-right-to-left shunt (PFO-RLS), physiological pulmonary-right-to-left shunt (P-RLS), pulmonary arteriovenous fistula (PAVF) and their combination types. The proportion and types of RLS between the migraine and CS groups was significantly different (χ Conclusions: Multi-modal echocardiography can identify the types and characteristics of RLS accurately, which may provide incremental value for clinical decision-making.
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