多层螺旋CT应用于检测房颤患者左心房血栓的价值

目的探讨多层螺旋CT评价房颤患者左心房血栓的价值。方法对120例房颤患者在同一次住院期间术前分别行多层螺旋CT及经食管超声检查,以经食管超声心动图为金标准,对多层螺旋CT检出左心房血栓情况进行评价。结果 120例中有107例诊断符合,多层螺旋CT与经食管超声心动图诊断符合率89.2%,多层螺旋CT检测左心房血栓的敏感度为54.5%,特异度为92.7%,阳性预测值为42.9%,阴性预测值为95.3%,阳性似然比7.48,阴性似然比0.49。两种检测方法的χ2值为0.31,两种方法检测左心房血栓无明显差异。结论多层螺旋CT能准确检出房颤患者左心房血栓,且可以一次成像,同时显示肺静脉及左心房形态,对指导治疗具有重要的价值。

Diagnostic value of multi-slice CT for detecting thrombosis in the left atrial among patients with atrial fibrillation

Objective To explore the value of multi-slice CT(MSCT) in detecting thrombosis in the left atrial among the patients with atrial fibrillation.Methods We evaluated 120 subjects with atrial fibrillation.Each patient received MSCT scan and trans-esophageal echocardiography(TEE) at the same time in hospital.The results of MSCT were compared with those of esophageal echocardiography as the gold standard.Results Among the results of MSCT,107 cases accorded with TEE in 120 subjects,and the diagnostic accordance rate was 89.2%.MSCT had a sensitivity of 54.5%,a specificity of 92.7%,a positive predictive value of 42.9%,and a negative predictive value of 95.3%,when compared with TEE as the gold standard.The effect of MSCT showed good agreement with TEE(χ2=0.31).Conclusion MSCT is an accurate method for thrombus detection in the LAA of patients with atrial fibrillation,which can show the anatomy of the pulmonary veins and left atrial at the same time.