Ohyama Hideo, Hosomi Naohisa, Takahashi Tsutomu, Mizushige Katsufumi, Osaka Kunihiko, Kohno Masakazu, Koziol James A
Second Department of Internal Medicine, Kagawa Medical University, 1750-1 Ikenobe, Miki-Cho, Kagawa 761-0793, Japan.
Stroke. 2003 Oct;34(10):2436-9. doi: 10.1161/01.STR.0000090350.73614.0F. Epub 2003 Sep 11.
A noninvasive technique of visualizing the left atrial appendage (LAA) and its thrombus in patients with atrial fibrillation would be of great interest. This study examined the utility of MRI for the assessment of thrombus in the LAA.
We evaluated 50 subjects with nonrheumatic continuous atrial fibrillation and a history of cardioembolic stroke. Each patient received an MRI and a transesophageal echocardiography (TEE) on the same day for thrombus detection in the LAA. Both double- and triple-inversion recovery sequences were used for the MRI evaluations.
In all subjects, the LAA was readily visualized with MRI. High-intensity masses in the LAA were clearly distinguishable from the LAA wall in the triple-inversion recovery sequences. Concordance between detection of high-intensity mass with MRI and thrombus with TEE was high: no mass (MRI), no thrombus (TEE), 31 patients; mass (MRI), thrombus (TEE), 16 patients; and mass (MRI), no thrombus (TEE), 3 patients (overall kappa=0.876, SE=0.068).
MRI is a noninvasive and reproducible modality for thrombus detection in the LAA of patients with nonrheumatic continuous atrial fibrillation and previous cardioembolic stroke.
一种用于可视化房颤患者左心耳（LAA）及其血栓的非侵入性技术将具有重大意义。本研究探讨了MRI在评估LAA血栓方面的效用。
我们评估了50例非风湿性持续性房颤且有心脏栓塞性卒中病史的患者。每位患者在同一天接受MRI和经食管超声心动图（TEE）检查，以检测LAA中的血栓。MRI评估使用了双反转恢复序列和三反转恢复序列。
在所有受试者中，MRI均可清晰显示LAA。在三反转恢复序列中，LAA内的高强度团块与LAA壁可明显区分。MRI检测到的高强度团块与TEE检测到的血栓之间的一致性很高：无团块（MRI），无血栓（TEE），31例患者；有团块（MRI），有血栓（TEE），16例患者；有团块（MRI），无血栓（TEE），3例患者（总体kappa=0.876，标准误=0.068）。
对于非风湿性持续性房颤且既往有心脏栓塞性卒中的患者，MRI是一种用于检测LAA血栓的非侵入性且可重复的检查方法。
