Analysis of imaging characteristics of patent foramen ovale-related cryptogenic stroke

Abstract

Cryptogenic ischemic stroke (CS) is an important risk factor for the death and disability of youngand middle-aged individuals. With the constant development of clinical medicine, it was found thatpatients with patent foramen ovale (PFO) have apparently higher risks of stroke than healthy people.Many scholars and some clinical scientists consider PFO as the main cause of stroke of unknown originoccurring in young and middle-aged. This study aimed to investigate the correlation between PFO andcryptogenic ischemic stroke and analyze the characteristics of cerebral Diffusion-weighted magneticresonance imaging (DW-MRI) of CS patients with PFO. One hundred and sixty-two young and middleagedpatients with CS who were admitted to our hospital between June 2014 and December 2016 wereselected. They were divided into a CS-PFO positive group (n = 106) and a CS-PFO negative group (n= 56) according to the results of contrast echocardiography of the right heart and transesophagealechocardiography. The results demonstrated that the percentage of CS patients with PFO wassignificantly higher than that without PFO, but the baseline data of the two groups had no significantdifference (P>0.05). The results of DWI suggested that infarct lesions of the CS-PFO negative groupwere mainly located in the cortex and sites which were more than 15 mm below the cortex compared tothe CS-PFO positive group, and the difference was statistically significant (P<0.05). Regarding vasculardistribution, infarct lesions of the two groups mainly located at the middle cerebral arteries (MCA),but the difference had no statistical significance (P>0.05). Thus, it is concluded that PFO may be animportant pathogenic factor for CS patients, infarct lesions of patients with CS and PFO mainly locateat the sites which were more than 15 mm below the cortex, and paradoxical embolism may be the mostprobable pathogenesis of PFO-induced cerebral infarction.