[Clinical study on left atrial thrombi: comparative study between echocardiography and CT scan (author's transl)]

We studied left atrial thrombi (LAT) by both echocardiography and computed tomography (CT) and compared the features of the 2 methods. A total of 15 patients with mitral stenosis complicated by atrial fibrillation were selected as the subjects. LAT were noted on the M-mode echocardiograms in 2 patients including a questionably positive one, on the two-dimensional echocardiograms in 5, and on the CT scans in 6 of 15. The history of thromboembolism was rather frequent and was found in 7 of 15 patients. However, LAT was found in only 3 of these on the CT scans. A shaggy or fuzzy pattern on the M-mode echocardiogram cannot be regarded as representing thrombi, while a laminar pattern undoubtedly represented thrombi. Two-dimensional echocardiography has considerably contributed to the improved detection rate of LAT. For the characteristic properties of ultrasound beams, however, it was impossible to investigate the entire left atrium. The detection of the thrombi in the appendage was especially difficult. However, computed tomography, permitting transverse cross-sectional tomography, was capable of sectioning the heart even in the presence of air and bones. The measurement of CT values was suggestive of the properties of the substance or substances involved, and also allowed the presumption as to whether the thrombus has been fibrosed. Furthermore, it was possible to estimate more accurately as well as 3-dimensionally the location, shape and dimensions of the thrombi by the reconstruction of the heart according to the CT values. It was concluded that echocardiography and computed tomography are the mutual aid to further improvement in the detection rate of left atrial thrombi.