title: Comparison of two contrast agents for right-to-left shunt diagnosis with contrast-enhanced transcranial Doppler.
abstract: We compared two contrast agents, agitated saline and agitated saline with blood, with respect to their efficacy in the diagnosis of right-to-left shunt with contrast-enhanced transcranial Doppler. Three hundred thirty Chinese patients underwent examinations with one of four different methods in random order: (i) 9 mL agitated saline solution with 1 mL air without the Valsalva maneuver (ASwoVM); (ii) 9 mL agitated saline solution with 1 mL air with the Valsalva maneuver (ASwVM); (iii) 9 mL agitated saline solution, 1 mL air and a drop of the patient's blood without the Valsalva maneuver (ASbwoVM); and (iv) 9 mL agitated saline solution, 1 mL air and a drop of the patient's blood, with the Valsalva maneuver (ASbwVM). Rates of detection were 11.5%, 17.9%, 16.7% and 23.6% for the ASwoVM, ASwVM, ASbwoVM, and ASbwVM examinations, respectively. The embolus track numbers for these examinations were 4.0 ± 1.83, 11.5 ± 6.2, 10.5 ± 4.9 and 33.7 ± 14.9, respectively. There were significant differences between the four groups (all comparisons, p < 0.001). For contrast-enhanced transcranial Doppler examinations, the agitated saline/blood agent yielded better rates of diagnosis of right to-left shunt than did the agitated saline alone.
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China.
authors.forename: Na
authors.initials: N
authors.lastname: Hao
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China.
authors.forename: Kangding
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China.
authors.forename: Zhen-Ni
authors.initials: ZN
authors.lastname: Guo
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China.
authors.forename: Xiujuan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China. Electronic address: doctor_yangyi@hotmail.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Neurology, First Norman Bethune Hospital of Jilin University, Changchun, China. Electronic address: Xingyq2009@sina.com.
authors.forename: Yingqi
authors.initials: Y
authors.lastname: Xing
mesh_terms: D000328:Adult; D000388:Air; D001769:Blood; D003287:Contrast Media; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D012965:Sodium Chloride; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014636:Valsalva Maneuver
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride
keywords: Contrast agent; Right-to-left shunt; Transcranial Doppler