Tomoda H, Hoshiai M, Furuya H, Kuribayashi S, Ootaki M, Matsuyama S, Koide S, Kawada S, Shotsu A
Am J Cardiol. 1983 Mar 1;51(5):843-52. doi: 10.1016/s0002-9149(83)80143-x.
Left atrial (LA) and left ventricular (LV) thrombus was evaluated by computed tomography in 56 patients. The patients were divided into 2 groups: Group I, 28 patients with mitral valve disease, and Group II, 28 patients with myocardial infarction. Computed tomography and 2-dimensional echocardiography were performed in all the patients studied. Cineangiocardiography was performed in all Group I and in 13 Group II patients. Open heart surgery or autopsy was performed in all Group I and 4 Group II patients. The sensitivity in detecting LA thrombus was 100% with computed tomography, 70% with angiocardiography, and 60% with 2-dimensional echocardiography. The specificity in detecting LA thrombus was 91% with computed tomography, 86% with 2-dimensional echocardiography, and 88% with angiocardiography. Thrombi located at the LA appendage were associated with great difficulties in detection by other methods, but were well delineated with computed tomography. LV thrombus was also visualized by computed tomography with similar or greater accuracy than other diagnostic methods, although the sensitivity and specificity were not ascertained because surgery or autopsy was performed in only a minority of Group II patients. Therefore, as far as the detection of intracardiac thrombus is concerned, computed tomography has the advantage of offering uniform slices of the heart in an attempt to detect thrombi in unknown areas of cardiac chambers, including the LA appendage or LV apex, without being disturbed by the surrounding cardiac and noncardiac structures. Thus, computed tomography has excellent accuracy in the detection of intracardiac thrombus.
通过计算机断层扫描对56例患者的左心房（LA）和左心室（LV）血栓进行了评估。患者被分为两组：第一组，28例二尖瓣疾病患者；第二组，28例心肌梗死患者。对所有研究患者均进行了计算机断层扫描和二维超声心动图检查。对所有第一组患者以及13例第二组患者进行了心血管造影电影摄影。对所有第一组患者和4例第二组患者进行了心脏直视手术或尸检。计算机断层扫描检测LA血栓的敏感性为100%，心血管造影为70%，二维超声心动图为60%。计算机断层扫描检测LA血栓的特异性为91%，二维超声心动图为86%，心血管造影为88%。位于LA附件的血栓用其他方法检测有很大困难，但计算机断层扫描能很好地显示。计算机断层扫描也能显示LV血栓，其准确性与其他诊断方法相似或更高，尽管由于仅对少数第二组患者进行了手术或尸检，未确定其敏感性和特异性。因此，就心内血栓的检测而言，计算机断层扫描的优势在于能提供心脏的均匀切片，试图检测心腔未知区域的血栓，包括LA附件或LV心尖，而不受周围心脏和非心脏结构的干扰。因此，计算机断层扫描在心内血栓检测方面具有出色的准确性。
