Wang YY, Xie L, Feng JB, Xu YY, Li CM. Right-to-left shunt detection in patent foramen ovale: The value of synchronized contrast transcranial Doppler and contrast transthoracic echocardiography. World J Radiol 2025; 17(5): 105951 [DOI: 10.4329/wjr.v17.i5.105951]
Corresponding Author of This Article
Chuan-Ming Li, MD, Professor, Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, No. 1 Jiankang Road, Yuzhong District, Chongqing 400014, China. lichuanming@hospital.cqmu.edu.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. May 28, 2025; 17(5): 105951 Published online May 28, 2025. doi: 10.4329/wjr.v17.i5.105951
Right-to-left shunt detection in patent foramen ovale: The value of synchronized contrast transcranial Doppler and contrast transthoracic echocardiography
Yu-Yin Wang, Lu Xie, Jun-Bang Feng, Yang-Yang Xu, Chuan-Ming Li
Yu-Yin Wang, Jun-Bang Feng, Chuan-Ming Li, Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China
Lu Xie, Department of Medical Technology, Community Health Center of YubeiLu in ShaPingBa, Chongqing 400000, China
Yang-Yang Xu, Department of Radiology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing 400000, China
Co-first authors: Yu-Yin Wang and Lu Xie.
Co-corresponding authors: Chuan-Ming Li and Yang-Yang Xu.
Author contributions: Wang YY and Xie L have contributed equally to this study, designed the case report, reviewed and edited the main document.; Feng JB, Xu YY and Li CM collected the data; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chuan-Ming Li, MD, Professor, Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, No. 1 Jiankang Road, Yuzhong District, Chongqing 400014, China. lichuanming@hospital.cqmu.edu.cn
Received: February 12, 2025 Revised: April 11, 2025 Accepted: April 28, 2025 Published online: May 28, 2025 Processing time: 103 Days and 23.1 Hours
Abstract
Patent foramen ovale (PFO) is a common congenital heart disorder associated with stroke, decompression sickness and migraine. Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography has important clinical significance and can improve the accuracy of detecting right-left shunts (RLSs) in patients with PFO. In this letter, regarding an original study presented by Yao et al, we present our insights and discuss how to better help clinicians evaluate changes in PFO-related RLS.
Core Tip: Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography enhances the accuracy of detecting right-left shunt (RLS) detection in patients with patent foramen ovale (PFO), who exhibit symptoms such as cryptogenic stroke, migraine, and dizziness. Nonetheless, this study has several limitations, such as the lack of reliability of the results and the low resolution of ultrasound technology. In addition, four-dimensional blood flow magnetic resonance imaging (MRI) is a new technology that has emerged in recent years and can be used to comprehensively evaluate cardiac blood flow patterns by quantifying hemodynamic parameters. It may help detect abnormal right atrial blood flow patterns in PFO and provide visualization of right-to-left shunting. Future studies should include a larger sample size with the gold standard and combine ultrasound and MRI to evaluate RLS alterations associated with PFO completely, thereby offering valuable information for precise diagnosis and treatment.
