Departments of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
Departments of General Thoracic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan.
Sci Rep. 2023 Mar 27;13(1):4965. doi: 10.1038/s41598-023-32240-0.
The purpose of this study is to clarify the feasibility of left atrial (LA) volume measurement and CHADS-VASc score for predicting the development of pulmonary vein (PV) stump thrombus after left upper lobectomy (LUL). The study population comprised 50 patients who underwent LUL for pulmonary lesions. All patients were evaluated for the development of PV stump thrombus at 7 days after LUL. LA volume was measured using preoperative CT and the CHADS-VASc score was evaluated. LA volume and CHADS-VASc score were compared between patients with and without the development of PV stump thrombus using the Mann-Whitney U test. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the accuracy of prediction of PV stump thrombus development. PV stump thrombus was detected in 17 (33.4%) of the 50 patients. LA volume was significantly greater in patients who developed PV stump thrombus than in those without thrombus (79.7 ± 19.4 vs. 66.6 ± 17.0 mL, p = 0.040). CHADS-VASc score was significantly higher in patients with PV stump thrombosis than in those without thrombus (3.4 ± 1.5 vs. 2.5 ± 1.5, p = 0.039). Area under the ROC curve values for predicting PV stump thrombus were 0.679, 0.676, and 0.714 for LA volume, CHADS-VASc score, and their combination, respectively. In conclusion, LA volume measured using preoperative CT and CHADS-VASc score may help predict the development of PV stump thrombus after LUL.
本研究旨在阐明左心房（LA）容积测量和 CHADS-VASc 评分预测左上肺叶切除术（LUL）后肺静脉（PV）残端血栓形成的可行性。研究人群包括 50 例因肺部病变行 LUL 的患者。所有患者均在 LUL 后 7 天评估 PV 残端血栓形成的发生情况。使用术前 CT 测量 LA 容积，并评估 CHADS-VASc 评分。采用 Mann-Whitney U 检验比较发生和未发生 PV 残端血栓形成的患者之间的 LA 容积和 CHADS-VASc 评分。采用受试者工作特征（ROC）曲线分析评估预测 PV 残端血栓形成的准确性。50 例患者中有 17 例（33.4%）检测到 PV 残端血栓。发生 PV 残端血栓形成的患者 LA 容积明显大于未发生血栓形成的患者（79.7±19.4 比 66.6±17.0 mL，p=0.040）。发生 PV 残端血栓形成的患者 CHADS-VASc 评分明显高于未发生血栓形成的患者（3.4±1.5 比 2.5±1.5，p=0.039）。预测 PV 残端血栓形成的 ROC 曲线下面积值分别为 LA 容积、CHADS-VASc 评分及其组合的 0.679、0.676 和 0.714。总之，术前 CT 测量的 LA 容积和 CHADS-VASc 评分可能有助于预测 LUL 后 PV 残端血栓形成。
