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Thrombus in the left atrial appendage in stroke patients: detection with cardiac CT angiography--a preliminary report

Jin Hur1, Young Jin Kim, Ji Eun Nam

  • 1Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, 250 Seongsanno (134 Sinchon-dong), Seodaemun-gu, Seoul 120-752, South Korea.

Radiology
|August 13, 2008
PubMed

Insights

Sixty-four-section cardiac CT angiography is a sensitive, noninvasive tool for detecting left atrial appendage thrombi in stroke patients. It shows high accuracy and may become a valuable alternative to transesophageal echocardiography.

Area of Science:

  • Cardiology
  • Radiology
  • Neurology

Background:

  • Left atrial appendage (LAA) thrombi are a significant cause of cardioembolic stroke.
  • Accurate detection of LAA thrombi is crucial for guiding stroke treatment and prevention strategies.

Purpose of the Study:

  • To evaluate the diagnostic performance of 64-section cardiac computed tomographic (CT) angiography in identifying LAA thrombi.
  • To compare the efficacy of cardiac CT angiography with transesophageal echocardiography (TEE) as the reference standard.

Main Methods:

  • Retrospective review of 101 stroke patients who underwent both 64-section cardiac CT angiography and TEE within one week.
  • Assessment of thrombus detection agreement between cardiac CT angiography and TEE using kappa statistics.

Main Results:

  • Cardiac CT angiography demonstrated high diagnostic accuracy for LAA thrombi, with 100% sensitivity and 95% specificity compared to TEE.
  • Overall concordance between the two imaging modalities was high (kappa = 0.779).
  • 12 thrombi were detected by cardiac CT angiography versus 8 by TEE.

Conclusions:

  • 64-section cardiac CT angiography is a sensitive and accurate noninvasive method for detecting LAA thrombi in stroke patients.
  • Cardiac CT angiography holds potential as a valuable tool for intracardiac thrombus detection, potentially complementing or replacing TEE.
Abstract

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