Comparison of magnetic resonance imaging and transesophageal echocardiography in detection of thrombus in the left atrial appendage

被引:85
作者
Ohyama, H
Hosomi, N
Takahashi, T
Mizushige, K
Osaka, K
Kohno, M
Koziol, JA
机构
[1] Kagawa Med Univ, Dept Internal Med 2, Miki, Kagawa 7610793, Japan
[2] Osaka Neurosurg Hosp, Kagawa, Japan
[3] Scripps Res Inst, Dept Mol & Expt Med, La Jolla, CA 92037 USA
关键词
atrial fibrillation; magnetic resonance imaging; stroke; cardioembolic; thrombi;
D O I
10.1161/01.STR.0000090350.73614.0F
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-A noninvasive technique of visualizing the left atrial appendage (LAA) and its thrombus in patients with atrial fibrillation would be of great interest. This study examined the utility of MRI for the assessment of thrombus in the LAA. Methods-We evaluated 50 subjects with nonrheumatic continuous atrial fibrillation and a history of cardioembolic stroke. Each patient received an MRI and a transesophageal echocardiography (TEE) on the same day for thrombus detection in the LAA. Both double- and triple-inversion recovery sequences were used for the MRI evaluations. Results-In all subjects, the LAA was readily visualized with MRI. High-intensity masses in the LAA were clearly distinguishable from the LAA wall in the triple-inversion recovery sequences. Concordance between detection of high-intensity mass with MRI and thrombus with TEE was high: no mass (MRI), no thrombus (TEE), 31 patients; mass (MRI), thrombus (TEE), 16 patients; and mass (MRI), no thrombus (TEE), 3 patients (overall kappa=0.876, SE=0.068). Conclusions-MRI is a noninvasive and reproducible modality for thrombus detection in the LAA of patients with nonrheumatic continuous atrial fibrillation and previous cardioembolic stroke.
引用
收藏
页码:2436 / 2439
页数:4
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