Enhanced Detection of Inftracardiac Sources of Cerebral Emboli by Transesophageal Echocardiography

J Korean Neurol Assoc > Volume 12(1); 1994 > Article

Journal of the Korean Neurological Association 1994;12(1): 10-21.

심인성 뇌색전증의 진단을 위한 경식도 심초음파도의 유용성

이태희, 조용원,박영춘,김권배,김기식

계명대학교 신경과, 내과.

Enhanced Detection of Inftracardiac Sources of Cerebral Emboli by Transesophageal Echocardiography

Tae Hee Lee, M.D., Yong Won Cho, M.D., Young Choon Park, M.D., Gwon Bae Kim, M.D., Kee Sik Kim, M.D.

Department of Neurology, Keimyung University School of medicine Department of Internal Medicine, Keimyung University School of medicine

Abstract

We studied 73 patients with ischemic stroke (56 patients) and transient ischemic attacks (17 patients) to evaluate the clinical efficacy of the two techniques, tansthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). For detecting potential intracardiac sources of cerebral emboli. Group I (40 cases) patients had no clinical cardiac abnorrnality. And group II (33 cases) patients had cardiac abnormality upon clinical examination. In group I. Intracardiac abnormalities were detected in 5%(2 to 40) with TTE and 37.5%(15 to 40) with TEE, and 34.2%(13 to 38) with TEE among the patients with normal finding with TTE which was statistically significant difference. In group II. Intracardiac abnormalities were detected in 21.1%(7 to 33) with TTE and 75.8%(25 to 33) with TEE, and 69.2% (18 to 26) with TEE arnong the patients with normal finding with TTE In comparison of 40 patients uith intracardiac source of embolism by echocardiogram (group A) and 33 patients without cardiac source of embolism(group B), atrial fibrillation was observed in 12 patients in group A versus 2 in group B (p<0.01), mean atrial size was 41.5mm in group A versus 35.3mm in group B. and left ventricular hypertrophy was in lQ in group A versus 6 in group B. Territories of cerebral arteries in cerebral infarction or TlAs of 40 patients with intracardiac source of embolism showed middle cerebral artery in 32.5%, posterior cerebral artery in 25% and bilateral or multiple in l2.5%. We concluded that TEE is superior to TTE for detecting potential cardiac sources of embolism. "