Detection of left atrial thrombus in patients with mitral stenosis and atrial fibrillation: retrospective comparison of two-phase computed tomography, transoesophageal echocardiography and surgical findings

Abstract

• Accurate detection of left atrial appendage (LAA) thrombus is extremely important. • However artefacts from flow effects influence both CT and ultrasound findings. • Two-phase ECG-gated CT offers new insight into thrombus detection. • Analysis of aortic/atrial opacification helps differentiate LAA thrombus from artefact at CT.

Extravascular incidental findings in run-off CT angiography in patients with acute limb ischaemia: incidence and clinical relevance

“…If the whole aorta is covered to detect possible sources of peripheral embolism, a less frequent cause of ALI, 37 the number of thoracic EVIF would have been higher. 38 In conclusion, the high incidence of immediately relevant incidental findings underlines the importance of interpreting all body regions included in a CT examination even if the clinical focus is on vascular evaluation. Doublereading should, therefore, be conducted, if possible, to reduce the risk of missing clinically relevant findings especially in the emergency situation of ALI,.…”

Usefulness of Dual-Phase Snapshot 320-Detector Computed Tomography for the Detection of a Left Atrial Appendage Thrombus

“…Addition of delayed scanning to early scanning caused extra radiation exposure to the patients (median: 0.42 mSv) in this study. While a statistical comparison would not be appropriate, slightly higher radiation exposure by 0.5-1.3 mSv was documented in previous manu-scripts dealing with 64-detector CT. 9,24) This minimum additional radiation exposure dose in the 320-detector CT in the present study was achieved by one-rotation scan without table displacement using a wider field of view.…”

“…In previous studies, the usefulness of the addition of delayed scanning in 64-detector CT performed for detecting FDs in the LAA was reported. 11,12,24) According to a meta-analysis, the diagnostic performance of delayed scanning for the detection of an FD in the LAA is actually high (the sensitivity, specificity, PPV, NPV, and accuracy were 100, 99, 92, 100, and 99%, respectively). 14) In the present study, we evaluated, for the first time, the diagnostic performance of delayed scanning in 320-detector CT for the detection of FDs in the LAA in a Japanese prospective population.…”

Giant Left Atrial Thrombus with Double Coronary Vascularization

“…Its occurrence increases with age and with the level of valvular obstruction3,4,8. In this condition, blood stasis on the left atrial appendage and LA favors the formation of multiple thrombi in those areas, therefore, it is very important to identify them due to the risk of systemic embolism and, less frequently, mechanical valve obstruction 2 , 8 .…”

“…However, the vascularized mass in the preoperative catheterization created doubts as to the nature of the mass. The discovery of a large mass in the LA in the echocardiogram forces the doctors to distinguish the cardiac myxoma and the thrombus, which are the most common aspects in cases of round masses in this chamber 8 .…”