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Left ventricular thrombus attenuation characterization in cardiac computed tomography angiography

Márcio Sommer Bittencourt1, Stephan Achenbach, Mohamed Marwan

  • 1Internal Medicine Division, University Hospital, University of São Paulo Medical School, Av. Lineu Prestes 2565, CEP: 05508-000, Butanta, Sao Paulo, Brazil. msbittencourt@bol.com.br

Journal of Cardiovascular Computed Tomography
|February 21, 2012
PubMed

Insights

Left ventricular thrombi have lower CT attenuation than the myocardial wall, aiding differentiation in contrast-enhanced coronary CT angiography. This measurement helps distinguish thrombi from heart muscle tissue.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Differentiating left ventricular thrombi from the myocardial wall in contrast-enhanced coronary computed tomography (CT) angiography is challenging due to similar visual appearances.
  • Accurate identification is crucial for appropriate patient management and treatment strategies.

Purpose of the Study:

  • To establish typical CT attenuation values for left ventricular thrombi.
  • To determine the utility of CT attenuation measurements in differentiating thrombi from myocardial tissue.

Main Methods:

  • Retrospective analysis of 31 patients with left ventricular thrombi identified on CT angiography over 6 years.
  • Assessment of CT attenuation (Hounsfield units) of thrombi, ascending aorta, left ventricle, and myocardial walls.
  • Calculation of mean attenuation values, differences, and ratios between these structures.

Main Results:

  • Mean CT attenuation of left ventricular thrombi was 43.2 ± 15.3 HU, significantly lower than myocardial walls (septal: 102.9 ± 23.1 HU; lateral: 99.3 ± 28.7 HU).
  • A CT attenuation threshold of 65 HU demonstrated high diagnostic performance (94-97%) for differentiating thrombi from myocardium.
  • Ratios of thrombus-to-aorta attenuation were significantly lower than myocardium-to-aorta ratios.

Conclusions:

  • CT attenuation is a valuable quantitative parameter for differentiating left ventricular thrombi from the myocardial wall in CT angiography.
  • Lower CT attenuation values within thrombi compared to myocardium can improve diagnostic accuracy.
Abstract

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