| Dual-Enhanced Cardiac CT for Detection of Left Atrial Appendage Thrombus in Patients With Stroke: A Prospective Comparison Study With Transesophageal Echocardiography. | |
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MedLine Citation:
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PMID: 21757676 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: A noninvasive method with high reliability and accuracy comparable to transesophageal echocardiography for identification of left atrial appendage thrombus would be of significant clinical value. The aim of this study was to assess the diagnostic performance of a dual-enhanced cardiac CT protocol for detection of left atrial appendage thrombi and for differentiation between thrombus and circulatory stasis in patients with stroke. METHODS: We studied 83 consecutive patients with stroke (56 men and 27 women; mean age, 62.6 years) who had high risk factors for thrombus formation and had undergone both dual-source CT and transesophageal echocardiography within a 3-day period. CT was performed with prospective electrocardiographic gating, and scanning began 180 seconds after the test bolus. RESULTS: Among the 83 patients, a total of 13 thrombi combined with spontaneous echo contrast and 14 spontaneous echo contrasts were detected by transesophageal echocardiography. All 13 thrombi combined with spontaneous echo contrast were correctly diagnosed on CT. Using transesophageal echocardiography as the reference standard, the overall sensitivity and specificity of CT for the detection of thrombi and circulatory stasis in the left atrial appendage were 96% (95% CI, 78% to 99%), and 100% (95% CI, 92% to 100%), respectively. On CT, the mean left atrial appendage/ascending aorta Hounsfield unit ratios were significantly different between thrombus and circulatory stasis (0.15 Hounsfield unit versus 0.27 Hounsfield unit, P=0.001). The mean effective radiation dose was 3.11 mSv. CONCLUSIONS: Dual-enhanced cardiac CT with prospective electrocardiographic gating is a noninvasive and sensitive modality for detecting left atrial appendage thrombus with an acceptable radiation dose. |
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Authors:
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Jin Hur; Young Jin Kim; Hye-Jeong Lee; Ji Eun Nam; Jong-Won Ha; Ji Hoe Heo; Hyuk-Jae Chang; Hua Sun Kim; Yoo Jin Hong; Hee Yeong Kim; Kyu Ok Choe; Byoung Wook Choi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-14 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Department of Radiology, Department of Cardiovascular Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea; the Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea; and the Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. |
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