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Multidetector computed tomography for detecting left atrial/left atrial appendage thrombus: a meta-analysis
1Department of Cardiology, The Second Affiliated Hospital/The Second Clinical Institute, Chongqing Medical University, Chongqing, China.
Internal Medicine Journal
|July 17, 2015
Summary
Multidetector computed tomography (MDCT) shows high accuracy for detecting left atrial/left atrial appendage (LA/LAA) thrombus. Optimized MDCT protocols significantly improve diagnostic performance and reduce heterogeneity, making it a viable alternative to TEE.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Diagnostic accuracy of multidetector computed tomography (MDCT) for left atrial/left atrial appendage (LA/LAA) thrombus detection is debated.
- Previous studies show controversial results regarding MDCT's effectiveness.
Purpose of the Study:
- To synthetically evaluate the diagnostic accuracy of MDCT in detecting LA/LAA thrombus.
- To compare MDCT with transesophageal echocardiography (TEE) for thrombus detection.
Main Methods:
- A meta-analysis of published prospective studies comparing MDCT and TEE for LA/LAA thrombus detection was conducted.
- Studies published before March 2014 were searched in PubMed and Embase.
- Data from 15 trials with 2540 patients were analyzed using MetaDiSc 1.4.
Main Results:
- Pooled analysis revealed high diagnostic accuracy for MDCT (SEN: 0.957, SPE: 0.917, AUC: 0.9883).
- Significant heterogeneity was observed between studies (P < 0.05, I(2) > 50%).
- Sub-analysis of studies with delayed imaging, ECG gating, and heart rate control showed improved accuracy and reduced heterogeneity (SEN: 0.991, SPE: 0.989, AUC: 0.9972).
Conclusions:
- MDCT is a potential alternative to TEE for LA/LAA thrombus detection, especially in patients with TEE intolerance or contraindications.
- Optimized MDCT protocols (delayed imaging, ECG gating, heart rate control) enhance diagnostic accuracy and reliability.
Keywords:
left atrial appendage thrombusleft atrial thrombusmultidetector computed tomographytransoesophageal echocardiographyMore Related Videos
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