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目的比较经食管超声心动图(TEE)和多层螺旋CT(MSCT)在左心房血栓诊断中的价值。方法收集我院在住院期间均行TEE和MSCT检查的病例,比较两种方法诊断左心房血栓的灵敏度和特异度。结果 MSCT与TEE诊断结果相符的共136例,其中均诊断为左心房正常的122例,均诊断为左心房血栓或血栓前期改变的14例,两种方法相比其差异具有统计学意义(χ~2=63.371,P=0.000)。以TEE为金标准,MSCT诊断左心房血栓的特异度为94.57%、灵敏度为73.68%、阳性似然比(LR+)为13.57、阴性似然比(LR-)为0.78、Youden指数为68.25%、诊断指数(DI)为168.25%、粗符合率为87.16%。结论 MSCT诊断左心房血栓的特异度和粗符合率较高,可作为TEE的补充性检查方法。
Objective To compare the value of transesophageal echocardiography (TEE) and multislice spiral CT (MSCT) in the diagnosis of left atrial thrombus. Methods We collected cases of TEE and MSCT during hospitalization and compared the sensitivity and specificity of the two methods in diagnosing left atrial thrombus. Results A total of 136 cases were diagnosed by MSCT and TEE. Among them, 122 cases were diagnosed as normal left atrium, and 14 cases were diagnosed as left atrial thrombus or thromboembolism, respectively. The differences between the two methods were statistically significant (χ ~ 2 = 63.371, P = 0.000). Using TEE as the gold standard, the specificity of MSCT in the diagnosis of left atrial thrombus was 94.57%, the sensitivity was 73.68%, the positive likelihood ratio (LR +) was 13.57, the negative likelihood ratio (LR-) was 0.78, the Youden index was 68.25% The diagnostic index (DI) was 168.25% and the crude coincidence rate was 87.16%. Conclusion MSCT diagnosis of left atrial thrombi specificity and rough coincidence rate can be used as a supplementary examination of TEE.