Dual-Energy CT for Diagnosis of Left Atrial Appendage Thrombosis in Patients with Atrial Fibrillation
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240907.014
- VernacularTitle:双能CT用于房颤患者左心耳部血栓的诊断
- Author:
Junya ZHAO
1
;
Mengting CHEN
1
;
Xuhui ZHOU
1
;
Taihui YU
2
Author Information
1. Department of Radiology，The Eighth Affiliated Hospital，Sun Yat-Sen University，Shenzhen 518033，China
2. Department of Radiology，Sun Yat-Sen Memorial Hospital，Sun Yat-Sen University，Guangzhou 510120，China
- Publication Type:Journal Article
- Keywords:
left atrial appendage;
thrombus;
dual-energy;
CT;
iodine concentration
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2024;45(5):745-754
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the diagnostic value of dual-energy computed tomography （DECT） for left atrial appendage thrombosis/spontaneous echocardiographic contrast （LAAT/SEC）. MethodsA retrospective analysis was done on 64 non-valvular atrial fibrillation patients who planned to undergo radiofrequency ablation between November 2020 and November 2021. All patients underwent DECT and transesophageal echocardiography （TEE）， and then were divided into LAAT/SEC group and non-LAAT/SEC group based on the TEE results. The clinical data and imaging parameters of the two groups were compared and analyzed. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for LAAT/SEC， and a prediction model was constructed. ResultsA total of 64 patients with atrial fibrillation were enrolled in this study， including 42 non-LAAT/SEC patients and 22 LAAT/SEC patients. There was no statistically significant difference in gender and body mass index （BMI） between the two groups （P > 0.05）. CHA2DS2-VASc score and left atrial diameter were higher in the LAAT/SEC group than in the non-LAAT/SEC group （P = 0.047； P < 0.001）. Significant differences （P < 0.001） were observed in the ratio of Hounsfield unit of LAA and ascending aorta （LAA/AA HU ratio） at the first phase of DECT and quantitative parameters such as Zeff， Rho， λHu， and nIC. Multivariate logistic regression showed that Zeff and Rho were the independent factors for the diagnosis of LAAT/SEC. A Zeff-Rho based model predicting LAAT/SEC was subsequently developed， with Area Under the Curve （AUC） of 0.96 （95% CI： 0.92， 1.00） and the accuracy of 0.92 （95% CI： 0.83， 0.97）. ConclusionsThe two quantitative parameters Zeff and Rho are independent risk factors for the diagnosis of LAAT/SEC. The DECT derived Zeff and Rho may have better diagnostic performance than single parameter and conventional CT in detecting LAAT/SEC.
