多层螺旋增强CT检查与实时三维经胸超声心动图检查对房颤患者射频消融治疗前评价左心耳血栓的诊断价值比较

DIAGNOSTIC VALUE OF MULTI-SLICE SPIRAL ENHANCED CT IN LEFT ATRIAL APPENDAGE THROMBUS BEFORE RADIOFREQUENCY ABLATION IN PATIENTS WITH ATRIAL FIBRILLATION

目的探讨射频消融治疗房颤患者前左心耳血栓评价中多层螺旋增强CT与实时三维经胸超声心动图的诊断价值对比分析。方法回顾性选取2020年2月—2022年12月该院房颤患者射频消融治疗患者150例。结果多层螺旋增强CT检查的灵敏性、阳性预测值均高于实时三维经胸超声心动图检查(P<0.05),但二者的特异度、准确性、阴性预测值之间的差异均不显著(P>0.05)。左心耳血栓患者的LAAVmax、LAAVmin均大于非左心耳血栓患者(P<0.05),LAAEF、LAAEV均小于非左心耳血栓患者,两者之间有显著性差异,但二者的左心耳口宽度、左心耳长度之间的差异均不显著(P>0.05)。左心耳血栓患者的左心耳形态鸡翅型比率低于非左心耳血栓(P<0.05),仙人掌型、风向袋型、菜花型比率均高于非左心耳血栓(P<0.05),左心房上下径、前后径、横径均大于非左心耳血栓(P<0.05),LAEV、LAEF小于非左心耳血栓(P<0.05)。结论射频消融治疗房颤患者前左心耳血栓评价中多层螺旋增强CT的诊断价值较高。

Objective To evaluate the diagnostic value of multi-slice spiral enhanced CT in left atrial appendage thrombus before radiofrequency ablation in patients with atrial fibrillation.Methods One hundred and fifty patients with atrial fibrillation treated by radiofrequency ablation in our hospital from February 2020 to December 2022 were retrospectively selected.Results The sensitivity and positive predictive value of multi-slice spiral CT were higher than those of real-time three-dimensional transthoracic echocardiography(P<0.05),but there was no significant difference in specificity,accuracy and negative predictive value between them(P>0.05).The LAAEF and LAAEV in patients with left atrial appendage thrombus were smaller than those in patients without left atrial appendage thrombus,LAAVmax and LAAVmin were larger than those in patients without left atrial appendage thrombus(P<0.05),and there were significant differences between the two,but the differences between the left atrial appendage width and the left atrial appendage length were not significant(P>0.05).The chicken wing shape ratio of left atrial appendage in patients with left atrial appendage thrombosis was lower than that in patients with non left atrial appendage thrombosis(P<o.05),and the ratio of cactus shape,wind bag shape and cauliflower shape was higher than that in patients with non left atrial appendage thrombosis(P<0.05).The upper and lower diameters,anterior and posterior diameters and transverse diameters of left atrium in patients with left atrial appendage thrombus were larger than those in patients without left atrial appendage thrombus(P<0.05),and LAEV and LAEF were smaller than those in patients without left atrial appendage thrombus(P<0.05).Conclusion MSCT is of high value in diagnosing left atrial appendage thrombus in patients with atrial fibrillation before radiofrequency ablation.