Objective To explore the application value of contrast transthoracic echocardiography (cTTE) and contrast-enhanced transcranial Doppler (cTCD) in the diagnosis of patent foramen ovale (PFO).

Methods A total of 110 patients with cryptogenic stroke, transient ischemic attack, or intractable migraine were selected. All enrolled patients were examined with cTTE and cTCD. TEE was used as the "gold standard" for diagnosing PFO. All patients excluded other structural heart diseases except PFO. The diagnostic rates and differences between a single method and a combination for diagnosing PFO were analyzed.

Results PFO was present in 88 of 110 patients with a prevalence of 80%. At rest state, cTTE diagnosed 57 cases of PFO, with a diagnostic rate of 70.00%, sensitivity of 63.64%, and specificity of 95.45%; 62 cases of PFO were diagnosed with cTCD, with a diagnostic rate of 72.73%, sensitivity of 68.18%, and specificity of 90.91%. There was no statistically significant difference between the two methods (P>0.05); under valsalva action, cTTE diagnosed 61 cases of PFO, with a diagnostic rate of 71.82%, sensitivity of 67.05%, and specificity of 90.91%; 73 cases of PFO were diagnosed with cTCD, with a diagnostic rate of 82.73%, sensitivity of 80.68%, and specificity of 90.91%. The diagnostic PFO of cTTE was lower than that of cTCD, and the difference between the two is statistically significant (P < 0.05); 83 cases of PFO were diagnosed by combining the two methods, with a diagnostic rate of 91.82%, sensitivity of 92.05%, and specificity of 90.91%. The combination of the two methods for diagnosing PFO was significantly higher than that of a single method, and the difference was statistically significant (P < 0.05).

Conclusions The combination of cTTE and cTCD for diagnosing PFO has a higher detection rate, easy operation, no pain, and accessible patient acceptance, which is worthy of clinical promotion.