Chaosuwannakit Narumol, Makarawate Pattarapong
Radiology Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40000, Thailand.
Cardiology Unit, Internal medicine Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Eur J Radiol Open. 2021 Feb 16;8:100330. doi: 10.1016/j.ejro.2021.100330. eCollection 2021.
Intracardiac thrombi are intermittently come across on cardiac computed tomography angiography (CCTA). This study aimed to examine the prevalence, outcome, and prognosis in patients with incidental found left-sided cardiac thrombi on CCTA.
The Ethics Committee approved the present study of the Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. A retrospective review of CCTA was performed for incidental left-sided cardiac thrombi.
A total of 1080 CCTAs were enrolled with the prevalence of incidental left-sided cardiac thrombi is 4.53%. Of the 49 patients with CCTA incidental left-sided cardiac thrombi, 16 had left atrial thrombi, and 33 had left ventricular thrombi. All thrombi were undetermined before the CCTA, and their identification subsequently generated anticoagulation treatment. In 10 patients, embolic complications happened, 4 of which were fatal. Patients with incidental detected left-sided intracardiac thrombi seen by CCTA had more embolic event than patients who did not discover left-sided intracardiac thrombi by CCTA (HR = 8.07; 95% CI 1.48-44.06; = 0.016).
Incidental left-sided cardiac thrombi on CCTA guided to management adjustments and seemed to present substantial mortality and morbidity in the present study. Physicians who interpret CCTA should ensure a dedicated effort not to disregard these prospective pitfalls.
心脏计算机断层扫描血管造影(CCTA)中偶尔会发现心内血栓。本研究旨在调查CCTA偶然发现左侧心内血栓患者的患病率、结局和预后。
泰国孔敬孔敬大学医学院伦理委员会批准了本研究。对偶然发现的左侧心内血栓进行CCTA回顾性分析。
共纳入1080例CCTA,偶然发现左侧心内血栓的患病率为4.53%。在49例CCTA偶然发现左侧心内血栓的患者中,16例有左心房血栓,33例有左心室血栓。所有血栓在CCTA检查前均未明确,其识别随后引发了抗凝治疗。10例患者发生栓塞并发症,其中4例死亡。CCTA偶然发现左侧心内血栓的患者比未通过CCTA发现左侧心内血栓的患者发生栓塞事件更多(HR = 8.07;95%CI 1.48 - 44.06;P = 0.016)。
在本研究中,CCTA偶然发现的左侧心内血栓导致了管理调整,似乎呈现出相当高的死亡率和发病率。解读CCTA的医生应确保做出专门努力,不要忽视这些潜在的陷阱。