Non-electrocardiography-gated dual-energy cardiac CT angiography for assessment of left atrial appendage thrombus  

作　　者：Feifei Zhang Tian Jiang Ruigang Xie Jiliang Zhang Minghua Sun Yinghui Ge 

机构地区：[1]Department of Radiology,Henan Provincial People's Hospital,Department of Radiology of Central China Fuwai Hospital,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 450003,China

出　　处：《Radiation Medicine and Protection》2024年第2期118-123,共6页放射医学与防护（英文）

基　　金：the Scientific Research Fund of Joint Construction Project of Henan Province and Ministry of Medical Science and Technology(No.SB201901097)China;Henan Provincial Key Laboratory of Cardiology Medical Imaging(No.2021-44-16),China.

摘　　要：Objective:To explore the diagnosis value of a low dose,dual-energy cardiac computed tomography angiography(CTA)with non-electrocardiography-gated(non-ECG-gated)in detecting left atrial appendage(IAA)thrombus.Methods:Consecutive patients with atrial fibrillation who underwent cardiac CTA protocol(dual-energy scan for arterial phase and conventional scan for delayed phase)were prospectively enrolled.LAA lesions were proved by clinical comprehensive diagnosis,the final study included 18 cases with LAA thrombus and 48 cases with circulatory stasis.Quantitative parameters derived from dual-energy images were measured for the LAA lesions,including the conventional CT attenuation value(CT value),iodine concentration(IC),normalized iodine concentration(NIC),effective atomic number values(Zeff)and energy spectrum curve slope(Slope).The differences between LAA thrombus group and circulatory stasis group were compared by independent sample t-test or Wilcoxon rank sum test regarding to the normality test.The diagnosis performance of the dual-energy parameters was assessed using receiver operating characteristic(ROC)curve analysis and area under curve(AUC).Results:All the dual-energy parameters were demonstrated significantly difference between LAA thrombus and circulatory stasis group(P<0.05),and showed better diagnostic performance than the conventional CT value.ROC analysis revealed IC was the most predictive parameter with AUC equal to 0.836.The radiation dose in the arterial phase was(2.640.66)mSv.Conclusion:Dual-energy CTA scanning shows convincing diagnostic performance in detecting left atrial appendage thrombus with lower radiation dose,and may help reduce the need for delayed phase scan.

关 键 词：Dual-energy computed tomography Imaging Atrial fibrillation Left atrial appendage THROMBUS Circulatory stasis 

分 类 号：R54[医药卫生—心血管疾病]