Multimodal imaging in assessment of left atrium appendage

    Authors

    Keywords

    multimodal imaging, left atrium appendage

    DOI

    https://doi.org/10.15836/ccar2017.130

    Full Text

    Atrial fibrillation is an important factor associated with left atrium (LA) enlargement and thrombus formation in the LA appendage. Transesophageal echocardiography is the procedure of choice for assessment of dimension of the LA, as well as thrombus detection in the LA cavity or LA appendage. It can detect thrombi with a high degree of sensitivity and specificity varying from 93% to 100%. Cardiac CT represents a gold standard for the assessment of anatomy of the LA complex. The mean CT sensitivity for identifying thrombus in the LA was 81% and the mean specificity 90%. Because of the high spatial resolution and the excellent myocardial border detection magnetic resonance imaging (MRI) is considered the most accurate technique for the non-invasive assessment of atrial volumes. Cardiac magnetic resonance imaging helps in tissue characterization of various intra-atrial masses and thus differentiation between cardiac tumors and thrombi. Both CMR and cardiac CT currently represent very important imaging modalities used for the comprehensive evaluation of the LA. (1-3) In our work we show a small series of patients with suspected mass in the LA appendage on the transesophageal ultrasound in which a cardiac MSCT and/or cardiac MRI is performed.

    Literature

    1. Tops LF, van der Wall EE, Schalij MJ, Bax JJ. Multi-modality imaging to assess left atrial size, anatomy and function. Heart. 2007 Nov;93(11):1461–70. https://doi.org/10.1136/hrt.2007.116467
    2. Wu X, Wang C, Zhang C, Zhang Y, Ding F, Yan J. Computed tomography for detecting left atrial thrombus: a meta-analysis. Arch Med Sci. 2012 Dec 20;8(6):943–51. https://doi.org/10.5114/aoms.2012.32400
    3. Romero J, Husain SA, Kelesidis I, Sanz J, Medina HM, Garcia MJ. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):185–94. https://doi.org/10.1161/CIRCIMAGING.112.000153
    Cardiologia Croatica
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    Multimodal imaging in assessment of left atrium appendage

    Extended Abstract
    Issue4
    Published
    Pages130
    PDF via DOIhttps://doi.org/10.15836/ccar2017.130
    multimodal imaging
    left atrium appendage

    Authors

    Damir RaljevićORCIDOpatija, Croatia
    Davorka ŽagarORCIDOpatija, Croatia
    Vesna Pehar Pejčinović*ORCIDOpatija, Croatia
    Viktor PeršićORCIDOpatija, Croatia
    Dijana Travica SamsaOpatija, Croatia
    Ivo KalčićORCIDOpatija, Croatia
    Ingrid BuljanovićOpatija, Croatia

    *Correspondence email: pehar.vesna@gmail.com

    Full Text

    Atrial fibrillation is an important factor associated with left atrium (LA) enlargement and thrombus formation in the LA appendage. Transesophageal echocardiography is the procedure of choice for assessment of dimension of the LA, as well as thrombus detection in the LA cavity or LA appendage. It can detect thrombi with a high degree of sensitivity and specificity varying from 93% to 100%. Cardiac CT represents a gold standard for the assessment of anatomy of the LA complex. The mean CT sensitivity for identifying thrombus in the LA was 81% and the mean specificity 90%. Because of the high spatial resolution and the excellent myocardial border detection magnetic resonance imaging (MRI) is considered the most accurate technique for the non-invasive assessment of atrial volumes. Cardiac magnetic resonance imaging helps in tissue characterization of various intra-atrial masses and thus differentiation between cardiac tumors and thrombi. Both CMR and cardiac CT currently represent very important imaging modalities used for the comprehensive evaluation of the LA. (1–3)

    In our work we show a small series of patients with suspected mass in the LA appendage on the transesophageal ultrasound in which a cardiac MSCT and/or cardiac MRI is performed.

    Literature

    1. 1.
      Tops LF, van der Wall EE, Schalij MJ, Bax JJ. Multi-modality imaging to assess left atrial size, anatomy and function. Heart. 2007 Nov;93(11):1461–70.DOI
    2. 2.
      Wu X, Wang C, Zhang C, Zhang Y, Ding F, Yan J. Computed tomography for detecting left atrial thrombus: a meta-analysis. Arch Med Sci. 2012 Dec 20;8(6):943–51.DOI
    3. 3.
      Romero J, Husain SA, Kelesidis I, Sanz J, Medina HM, Garcia MJ. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):185–94.DOI