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Differentiation Between Spontaneous Echocardiographic Contrast and Left Atrial Appendage Thrombus in Patients With Suspected Embolic Stroke Using Two-Phase Multidetector Computed Tomography
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Kim, Soo Chin | - |
dc.contributor.author | Chun, Eun Ju | - |
dc.contributor.author | Choi, Sang Il | - |
dc.contributor.author | Lee, Sook-Jin | - |
dc.contributor.author | Chang, Hyuk-Jae | - |
dc.contributor.author | Han, Moon-Ku | - |
dc.contributor.author | Bae, Hee-Joon | - |
dc.contributor.author | Park, Jae Hyung | - |
dc.date.accessioned | 2024-08-08T01:46:51Z | - |
dc.date.available | 2024-08-08T01:46:51Z | - |
dc.date.created | 2021-12-20 | - |
dc.date.created | 2021-12-20 | - |
dc.date.issued | 2010-10 | - |
dc.identifier.citation | American Journal of Cardiology, Vol.106 No.8, pp.1174-1181 | - |
dc.identifier.issn | 0002-9149 | - |
dc.identifier.uri | https://hdl.handle.net/10371/208079 | - |
dc.description.abstract | The detection of a thrombus at the left atrial appendage (LAA) is an important step for management in a patient with a suspected embolic infarction. However, spontaneous echocardiographic contrast (SEC), which can mimic thrombus, can confuse clinicians in many cases. We examined electrocardiographic-gated 64-slice multidetector computed tomography with a 2-phase scan and transesophageal echocardiography in 314 patients with suspected embolic stroke. The transesophageal echocardiographic findings were classified using a 5-grade scale and the multidetector computed tomographic findings were categorized as no filling defect, an early filling defect (a filling defect seen on early-phase images without considering the late-phase images), and a persistent filling defect (a filling defect seen on added late-phase images, as well as on early-phase images). For quantitative analysis, the ratio of Hounsfield units in the LAA to the ascending aorta (AA) was calculated for each early-phase and late-phase image (LAA/AA(L)). Using transesophageal echocardiography as the reference standard, for no filling defect seen on early-phase images, the presence of a thrombus, including severe SEC, could be ruled out with 100% sensitivity and a 100% negative predictive value. When considering the addition of late-phase images, all persistent filling defects had resulted from the presence of a thrombus and severe SEC. However, using the optimal cutoff value of 0.5 for the LAA/AA(L) ratio, thrombi could be distinguished from severe SEC where all thrombi had a LAA/AA(L) ratio <0.5. In conclusion, our findings suggest that 2-phase multidector computed tomography is useful for the detection and differentiation of a thrombus from SEC at the LAA in patients with suspected embolic stroke. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010; 106:1174-1181) | - |
dc.language | 영어 | - |
dc.publisher | Excerpta Medica, Inc. | - |
dc.title | Differentiation Between Spontaneous Echocardiographic Contrast and Left Atrial Appendage Thrombus in Patients With Suspected Embolic Stroke Using Two-Phase Multidetector Computed Tomography | - |
dc.type | Article | - |
dc.identifier.doi | 10.1016/j.amjcard.2010.06.033 | - |
dc.citation.journaltitle | American Journal of Cardiology | - |
dc.identifier.wosid | 000283568700022 | - |
dc.identifier.scopusid | 2-s2.0-77957752267 | - |
dc.citation.endpage | 1181 | - |
dc.citation.number | 8 | - |
dc.citation.startpage | 1174 | - |
dc.citation.volume | 106 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Han, Moon-Ku | - |
dc.contributor.affiliatedAuthor | Bae, Hee-Joon | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.subject.keywordPlus | MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY | - |
dc.subject.keywordPlus | CARDIAC CT ANGIOGRAPHY | - |
dc.subject.keywordPlus | ACUTE ISCHEMIC-STROKE | - |
dc.subject.keywordPlus | FILLING DEFECTS | - |
dc.subject.keywordPlus | CLASSIFICATION | - |
dc.subject.keywordPlus | FIBRILLATION | - |
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