摘要
目的:使用联影宽探测器UCT960320层CT行冠状动脉CTA(CCTA)双期扫描,探讨CCTA双期扫描在非瓣膜性心房颤动(房颤)患者左心耳血栓筛查中的应用价值。方法:选取拟行心脏射频消融术或左心耳封堵术的109例非瓣膜性房颤患者,行CCTA双期扫描及经食管超声心动图(TEE)检查;将CT原始图像传入后处理工作站,行MIP、MPR、VR等后处理,观察左心耳有无血栓;以TEE检查结果为金标准,评价CCTA双期扫描对左心耳血栓的诊断效能及与TEE的一致性。同时利用心功能软件,获得左心耳三维图像进行形态分型,测量左心耳开口处径线及深度,并分析其与左心耳血栓形成的关系。结果:以TEE检查结果为金标准,CCTA双期扫描诊断左心耳血栓的敏感度、特异度、阳性预测值、阴性预测值,分别为94.7%、97.6%、90.0%、98.8%,2种检查的符合率为97.0%。血栓组较无血栓组的左心耳开口长径和短径明显增大、非鸡翅膀型比例明显增加,差异均有统计学意义(均P<0.05);但左心耳深度两者差异无统计学意义(P>0.05)。结论:宽探测器CCTA双期扫描可为临床提供一种安全、客观、高效的左心耳血栓检测方法。左心耳形态的复杂程度和左心耳开口径线是左心耳血栓形成的相关危险因素。
Objective:To investigate the application of coronary CTA(CCTA)dual-phase scaning in screening of left atrial appendage(LAA)thrombus in patients with non-valvular atrial fibrillation.CCTA examination was done with United Imaging wide-detector UCT960320-slice CT.Methods:A total of 109 patients with non-valvular atrial fibrillation who were going to undergo cardiac radiofrequency ablation or LAA closure were selected,and all patients underwent double-phase CCTA scan and trans-esophageal echocardiography(TEE),and the original CT image was subjected to MIP,MPR,VR and other reconstruction methods to observe LAA thrombus.Taking TEE results as the gold standard,the diagnostic efficiency of CCTA dual-phase scanning and the consistency of the two examinations were analyzed.At the same time,the cardiac function software was used to obtain LAA three-dimensional images for morphological typing,the diameter and depth of the LAA opening were measured,and the related risk factors for LAA thrombus were analyzed.Results:Taking TEE examination results as the gold standard,the sensitivity,specificity,positive predictive value and negative predictive value of CCTA dual-phase scanning in the diagnosis of LAA thrombus were 94.7%,97.6%,90.0%,98.8%,and the coincidence rate of the two examinations was 97.0%.The long and short diameters of the LAA opening in the thrombus group were significantly larger than those in the non-thrombotic group,and the proportion of non-chicken-wing type was significantly increased(P<0.05).However,there was no significant difference in the LAA depth(P>0.05).Conclusions:Wide-detector CCTA dual-phase scanning can provide a safe,objective and efficient method for the detection of LAA thrombus.LAA morphology and LAA caliber line are related risk factors for LAA thrombosis.
作者
李春晨
尹小花
程韬
梁凯轶
LI Chunchen;YIN Xiaohua;CHEN Tao;LIANG Kaiyi(Department of Radiology,Jiading District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences,Shanghai 201800,China)
出处
《中国中西医结合影像学杂志》
2023年第2期145-149,共5页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
上海市卫健委智慧影像重点实验室、上海市嘉定区医学重点专科(2020-jdyxzdzk-02)
上海市嘉定区卫生健康委科研项目(2021-KY-02)。
