Application value of multi-phase left atrial appendage CTA imaging with pulmonary artery monitoring in preoperative evaluation of left atrial appendage closure
10.3969/j.issn.1671-8348.2025.06.014
- VernacularTitle:肺动脉监测多期相左心耳CTA成像在左心耳封堵术前评估中的应用价值
- Author:
Bocheng WANG
1
;
Yunting MEI
;
Bingyi FANG
;
Qiufang ZHU
;
Haoqing PAN
;
Haisheng LIANG
;
Bingbing SUN
;
Can WANG
;
Jing ZHOU
Author Information
1. 上海交通大学医学院附属第九人民医院放射科,上海 200011
- Keywords:
left atrial appendage;
multi-phase;
thrombus;
peri-thrombotic area;
left atrial appendage clo-sure
- From:
Chongqing Medicine
2025;54(6):1356-1360
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of 320-slice wide-detector multi-phase left at-rial appendage computed tomography angiography(LAA-CTA)with pulmonary artery(PA)monitoring in the preoperative evaluation of left atrial appendage closure.Methods A retrospective analysis was conducted on the clinical data of 110 patients who underwent LAA-CTA before left atrial appendage closure.Among them,47 patients underwent single-phase enhanced scanning with superior vena cava(SVC)monitoring(con-trol group),and 63 patients underwent multi-phase enhanced scanning with pulmonary artery monitoring(study group).The differences in imaging effects of the left atrial appendage under different monitoring points and phase imaging methods were compared,as well as the accuracy of comparing with the diagnostic results of transesophageal ultrasound(TEE),and the differences in the presentation of thrombus,perithrombus,and hypoperfusion areas in the left atrial appendage.Results The study group could comprehensively display the multi-phase CT value changes of different components(thrombus,peri-thrombotic viscosity,normal blood)within the left atrial appendage cavity,and its evaluation of lesion size and progression was superior to that of the control group.Using TEE as the gold standard,the study group demonstrated better diagnostic ac-curacy for different components and normal regions within the left atrial appendage cavity compared to the control group(P<0.001).Additionally,the study group improved the detection rate of peri-thrombotic vis-cosity,clearly delineated thrombus boundaries,and enhanced diagnostic accuracy(P<0.001).Conclusion Multi-phase LAA-CTA with pulmonary artery monitoring can effectively evaluate the morphological dimensions,thrombus,and peri-thrombotic CT manifestations of the left atrial appendage.It is simple to operate,with an accuracy rate close to the gold standard,providing reliable imaging evidence for preoperative evaluation of left atrial appendage closure.
