{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:05:45Z","timestamp":1773104745780,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T00:00:00Z","timestamp":1619049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Transcranial Doppler ultrasound (TCD) is noninvasive and highly sensitive and specific for the diagnosis of patent foramen ovale (PFO). We evaluated the diagnostic implications of the TCD with a saline agitation test as a routine work\u2010up for ischemic stroke patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A TCD bubble study was performed in all consecutive ischemic stroke patients as a routine work\u2010up. We evaluated the prevalence of microembolic signals (MES) for each stroke etiology and the optimal number of MES for predicting the PFO\u2010attributable stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Subjects (<jats:italic>N<\/jats:italic>\u00a0=\u00a0499) with acute ischemic stroke were enrolled. A significant fraction of patients had MES during both normal respiration (5.7\u201344.4%) and the Valsalva maneuver (19.5\u201355.6%) across all stroke etiology categories. The optimal MES threshold for the diagnosis of PFO\u2010attributable stroke confirmed by transesophageal echocardiography was 46 MES during the Valsalva maneuver (96% sensitivity and 95% specificity). Applying \u226546 MES during the Valsalva maneuver as a threshold effectively increased the ability to differentially diagnose PFO\u2010attributable stroke from other etiologies. The number of MES during the Valsalva maneuver was negatively correlated with increasing age (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.108; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A significant fraction of patients had right to left shunt across all Trial of ORG 10172 in Acute Stroke Treatment etiologies. A threshold number of MES facilitated the differential diagnosis of PFO\u2010attributable stroke from other etiologies, and the optimal threshold was 46 MES during the Valsalva maneuver.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15724","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T17:13:05Z","timestamp":1619111585000},"page":"439-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Prevalence of Microembolic Signals in Transcranial Doppler Sonography With Bubble Test in Acute Ischemic Stroke"],"prefix":"10.1002","volume":"41","author":[{"given":"Hyunji","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Neurology College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7071-1455","authenticated-orcid":false,"given":"Taewon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u2010Uk","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurology College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung\u2010Woo","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea  Seoul South 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