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Accuracy of cardiac CT in evaluating severity of left atrial appendage spontaneous echo contrast: comparison with transesophageal echocardiography
- Source :
- The International Journal of Cardiovascular Imaging. 34:1147-1154
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- To investigate the capacity of biphasic cardiac CT (CCT) for qualitative and quantitative evaluation of different grades of left atrial appendage spontaneous echo contrast (LAASEC). The study included 267 inpatients with confirmed atrial fibrillation who underwent both CCT and transesophageal echocardiography (TEE). CT numbers for LAA, ascending aorta (AA), and left atrium (LA) were identified, and ROC curves for LAA, LAA/AA, and LAA/LA were plotted. With TEE as the standard, the sensitivity, specificity, PPV, NPV, and accuracy of CCT for LAASEC grade ≥ 1 were 60.3, 92.9, 92.4, 64.8, and 75.7%; and for grade ≥ 2 were 100.0, 84.4, 71.4, 100.0, and 88.8% respectively. The values of LAA, LAA/AA, and LAA/LA were significantly larger in LAASEC grade 0 versus 1 and in grade 1 versus 2, but were similar in grades 2 and 3 or in grades 3 and 4. The values of LAA/AA were larger in grade 2 versus 4. When the cutoff value for LAA/AA = 0.897, sensitivity, specificity, PPV, NPV, and accuracy of CCT for LAASEC grade ≥ 1 was 89.6, 83.2, 87.9, 85.5, and 86.9% and with a cutoff for LAA/AA of 0.524, the sensitivity, specificity, PPV, NPV, and accuracy for LAASEC grade ≥ 2 was 98.7, 92.7, 84.1, 99.4, and 94.4%. Although CCT showed limited diagnostic accuracy for grade 1 LAASEC, grade ≥ 2 LAASEC could be excluded when there was no LAA filling defect on first-phase CCT, and TEE can be avoided. CCT has an excellent accuracy in diagnosing LAASEC, and quantitative analysis (in particular LAA/AA) is superior.
- Subjects :
- Adult
Male
Heart Diseases
Spontaneous echo contrast
Contrast Media
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Left atrial
medicine.artery
Hounsfield scale
Atrial Fibrillation
Ascending aorta
medicine
Humans
Cutoff
Atrial Appendage
Radiology, Nuclear Medicine and imaging
Cardiac imaging
Aged
Retrospective Studies
Aged, 80 and over
Receiver operating characteristic
business.industry
Thrombosis
Atrial fibrillation
Middle Aged
medicine.disease
Cardiac Imaging Techniques
Female
Tomography, X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Nuclear medicine
Echocardiography, Transesophageal
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15730743 and 15695794
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- The International Journal of Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....9f4dcc54b56652f14756d55ab50a4be1