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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

Computed tomography for detecting left atrial thrombus: a meta-analysis

Xiaosan Wu1, Congxia Wang, Chunyan Zhang

  • 1Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical School, Xi'an Jiaotong University, Shaanxi, China.

Archives of Medical Science : AMS
|January 16, 2013
PubMed

Insights

Computed tomography (CT) accurately detects left atrial and appendage thrombus, a complication of atrial fibrillation. This noninvasive imaging method shows high sensitivity and specificity, making it a valuable alternative to transesophageal echocardiography.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Atrial fibrillation frequently leads to thromboembolism from the left atrium (LA) and left atrial appendage (LAA), causing stroke.
  • Computed tomography (CT) offers a noninvasive approach for identifying LA/LAA thrombus.
  • The diagnostic accuracy of CT for LA/LAA thrombus requires comprehensive evaluation.

Purpose of the Study:

  • To perform a meta-analysis evaluating the diagnostic accuracy of CT in detecting LA/LAA thrombus.
  • To compare CT's performance against transesophageal echocardiography as a reference standard.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Medline, ISI Web of Knowledge, Cochrane Library) up to June 2012.
  • Meta-analysis techniques were employed to pool sensitivity and specificity data.
  • Summary receiver operating characteristic (SROC) curves were constructed to assess overall diagnostic performance.

Main Results:

  • Nine studies comprising 1646 patients were included in the meta-analysis.
  • CT demonstrated a mean sensitivity of 81% (95% CI: 70-90%) and specificity of 90% (95% CI: 88-91%) for LA/LAA thrombus detection.
  • The SROC analysis yielded an area under the curve of 0.93, indicating strong diagnostic capability.

Conclusions:

  • Computed tomography exhibits significant diagnostic accuracy for detecting LA/LAA thrombus.
  • CT is a highly sensitive and specific noninvasive imaging modality.
  • CT represents a primary noninvasive alternative to transesophageal echocardiography for LA/LAA thrombus identification, warranting further patient-level randomized trials.
Abstract

Keywords:
computed tomographyleft atrial thrombusmeta-analysistransesophageal echocardiography

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