Department of Radiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, Hebei 061001, China.
Comput Math Methods Med. 2022 May 14;2022:8679511. doi: 10.1155/2022/8679511. eCollection 2022.
The accuracy of left atrial pulmonary vein CT enhanced single-phase and dual-phase scanning in the detection of left atrial appendage (LAA) thrombosis and spontaneous echo contrast (SEC) before radio frequency ablation was compared in atrial fibrillation patients, so as to optimize the scanning scheme.
78 patients with atrial fibrillation who were admitted to Cangzhou Central Hospital from October 2020 to September 2021 and underwent bilateral enhanced CT scan of left atrial pulmonary vein and transesophageal echocardiography (TEE) examination for planned frequency ablation were selected. TEE results were used as the "gold standard" to compare the diagnostic efficacy of the first phase, second phase, and double-phase comprehensive mode of enhanced left atrial pulmonary vein CT in detecting left atrial thrombosis and SEC.
The sensitivity, specificity, positive predictive value, and negative predictive value were 88.9%, 84.1%, 42.1%, and 98.3%, respectively, in the detection of left atrial thrombosis and SEC by the first phase of CT enhanced scan. The sensitivity, specificity, positive predictive value, and negative predictive value were 22.2%, 98.6%, 66.6%, and 90.7%, respectively, in the detection of left atrial thrombosis and SEC by the second phase of CT enhanced scan. The sensitivity, specificity, positive predictive value, and negative predictive value were 88.9%, 84.1%, 42.1%, and 98.3%, respectively, in the detection of left atrial thrombosis and SEC by the double-phase comprehensive mode of CT enhanced scan. There was no statistically significant difference in the accuracy of CT diagnosis of left atrial appendage thrombosis and SEC between the three modes of the first phase, the second phase, and the double-phase comprehensive CT ( > 0.05). The mean effective radiation dose of double-phase enhanced scan was 7.49 ± 1.02 mSv.
Single-phase enhanced CT scan of left atrial pulmonary vein can meet clinical requirements and significantly reduce the radiation dose compared with double-phase enhanced CT scan. Therefore, it is recommended as an initial screening examination for patients with atrial fibrillation before radiofrequency ablation.
比较房颤患者左心房肺静脉 CT 增强单相和双相扫描在射频消融前检测左心房附壁血栓（LAA）和自发性回声对比（SEC）的准确性，从而优化扫描方案。
选取 2020 年 10 月至 2021 年 9 月在沧州市中心医院因计划行射频消融而接受双侧左心房肺静脉增强 CT 扫描和经食管超声心动图（TEE）检查的 78 例房颤患者。以 TEE 结果为“金标准”，比较增强左心房肺静脉 CT 单相、双相及双相综合模式对左心房血栓和 SEC 的诊断效能。
CT 增强扫描单相检查诊断左心房血栓和 SEC 的灵敏度、特异度、阳性预测值、阴性预测值分别为 88.9%、84.1%、42.1%、98.3%；CT 增强扫描双相检查诊断左心房血栓和 SEC 的灵敏度、特异度、阳性预测值、阴性预测值分别为 22.2%、98.6%、66.6%、90.7%；CT 增强扫描双相综合模式检查诊断左心房血栓和 SEC 的灵敏度、特异度、阳性预测值、阴性预测值分别为 88.9%、84.1%、42.1%、98.3%。三种模式 CT 诊断左心房附壁血栓和 SEC 的准确率差异均无统计学意义（>0.05）。双相增强扫描的平均有效辐射剂量为 7.49±1.02mSv。
左心房肺静脉单相增强 CT 扫描可满足临床要求，与双相增强 CT 扫描相比，可显著降低辐射剂量。因此，建议作为房颤患者射频消融前的初始筛选检查。
