Jin Hur MD, Presenter: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Young Jin Kim MD, Abstract Co-Author: Nothing to Disclose

Hye-Jeong Lee MD, Abstract Co-Author: Nothing to Disclose

Ji Eun Nam MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

We determined and compared the diagnostic accuracy of two-phase 64-slice cardiac computed tomographic angiography (CCTA) and transesophageal echocardiography (TEE) for detection of LAA thrombi and for differentiation between thrombus and SEC in stroke patients.

We selected 55 patients who had experienced a recent episode of stroke, had high-risk factors for thrombus formation and had undergone both two-phase 64-slice CCTA and TEE within a period of 5 days. For quantitative analysis, the Hounsfield unit (HU) density was measured in the LAA and ascending aorta (AA) of the same slice to calculate an LAA/AA HU ratio for thrombus and SEC on early- and late-phase images.

In 55 patients, a total of 14 thrombi were detected by TEE. Using TEE as the reference standard, the overall sensitivity, specificity, positive predictive value and negative predictive value of 64-slice CCTA for detecting thrombus in the LAA were 100%, 97%, 93%, and 100%, respectively. The concordance between the detection of thrombus in the LAA with 64-slice CCTA and TEE was high (overall κ=0.953).The mean LAA/AA HU ratios were significantly different between thrombus and SEC on late-phase images (0.29 HU ± 0.12, and 0.85 HU ± 0.12, respectively (p < 0.01)).

We found that two-phase 64-slice CCTA is a non-invasive and very sensitive modality for detecting LAA thrombus and differentiating between thrombus and SEC in stroke patients.

Two-phase 64-slice CCTA is a non-invasive and very sensitive modality for detecting LAA thrombus and differentiating between thrombus and SEC in stroke patients.

Hur, J, Choi, B, Kim, Y, Lee, H, Nam, J, Choe, K, Two-Phase Cardiac Computed Tomographic Angiography for Detection of Thrombus in the Left Atrial Appendage in Stroke Patients: Comparison with Transesophageal Echocardiography.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6015443.html