Publication Name	World Journal of Radiology
Manuscript ID	105951
Country	China

Category	Radiology, Nuclear Medicine & Medical Imaging
Manuscript Type	Letter to the Editor
Article Title	Right-to-left shunt detection in patent foramen ovale: The value of synchronized contrast transcranial Doppler and contrast transthoracic echocardiography
Manuscript Source	Invited Manuscript
All Author List	Yu-Yin Wang, Lu Xie, Jun-Bang Feng, Yang-Yang Xu and Chuan-Ming Li
Funding Agency and Grant Number
Corresponding Author	Chuan-Ming Li, MD, Professor, Department of Medical Imaging, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, No. 1 Jiankang Road, Yuzhong District, Chongqing 400014, China. lichuanming@hospital.cqmu.edu.cn
Key Words	Contrast transcranial Doppler; Contrast transthoracic echocardiography; Combined multimodal ultrasound; Patent foramen ovale; Right-to-left shunt
Core Tip	Combining synchronized contrast transcranial Doppler with contrast transthoracic echocardiography enhances the accuracy of detecting right‒left shunt (RLS) detection in patients with patent foramen ovale (PFO), who exhibit symptoms such as cryptogenic stroke, migraine, and dizziness. Nonetheless, this study has several limitations, such as the lack of reliability of the results and the low resolution of ultrasound technology. In addition, four-dimensional blood flow magnetic resonance imaging (MRI) is a new technology that has emerged in recent years and can be used to comprehensively evaluate cardiac blood flow patterns by quantifying hemodynamic parameters. It may help detect abnormal right atrial blood flow patterns in PFO and provide visualization of right-to-left shunting. Future studies should include a larger sample size with the gold standard and combine ultrasound and MRI to evaluate RLS alterations associated with PFO completely, thereby offering valuable information for precise diagnosis and treatment.
Citation	Wang YY, Xie L, Feng JB, Xu YY, Li CM. Right-to-left shunt detection in patent foramen ovale: The value of synchronized contrast transcranial Doppler and contrast transthoracic echocardiography. World J Radiol 2025; In press

Received	2025-02-12 06:39
Peer-Review Started	2025-02-12 06:39
To Make the First Decision
Return for Revision	2025-04-02 11:19
Revised	2025-04-11 07:35
Second Decision	2025-04-28 02:36
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-04-28 08:08
Articles in Press	2025-04-28 08:08
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Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8470 (online)
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