Objective: To evaluate feasibility and efficacy of 64— slice spiral computed tomography diagnosing left atrial thrombus and pulmonary venous with angiography in patients with atrial fibrillation. Methods: A total of 51 patients with atrial fibrillation, who with mitral stenosis intended to balloon catheter technique or radiofrequency ablation were regularly examined for left atrial thrombus and pulmonary venous with 64— slice spiral CT angiography (CTA). After examination, those who were found left atrial thrombus were enrolled as experimental group, and cases without left atrial thrombus were regard as control group. All cases were examined by transesophageal echocardiography (TEE), and measured left atrial volume (LAV) while receiving CTA( blood level of brain natriuretic peptide (BNP) was measured before CTA. Results: A total of 11 cases with left atrial thrombus and 40 cases without left atrial thrombus were found in 51 patients with atrial fibrillation by CTA, and they were all proved by TEE-, compared with atrial fibrillation without thrombus group, level of BNP [ (168. 10±50. 68) pg/ml vs. (253. 03±150. 88) pg/ml] and LAV [ (150. 55±47. 44) cm2 vs. (229. 10±104. 96) cm2] significantly increased in atrial fibrillation with left atrial thrombus group, P＜0. 05 both. Conclusion: Left atrial and pulmonary venous CTA can find the existence of left atrial thrombus in patients with atrial fibrillation, and it' s an noninvasive method.%目的:评价64排螺旋CT行左房及肺静脉计算机断层血管摄影术(CTA)诊断左房血栓的可行性及有效性.方法:51例需行房颤射频消融术或二尖瓣狭窄伴房颤患者拟行球囊扩张术前常规行左房及肺静脉CTA检查,有左房血栓的病例作为实验组,未提示左房血栓的病例作为对照组.所有病例均行经食道超声检查(TEE),且在行左房及肺静脉CTA检查时测量左房容积(LAV).检查前均抽取静脉血检查脑钠肽(BNP)水平.结果:51例房颤患者CTA检测出左房血栓11例,无左房血栓40例,均经TEE检测证实;与房颤无血栓组比较,房颤伴左房血栓组BNP水平明显升高[(168.10±50.68)pg/ml比(253.03±150.88)pg/ml],LAV明显增大[(150.55±47.44)cm2比(229.10±104.96)cm2],P均<0.05.结论:房颤患者行左房及肺静脉CTA检查可以发现是否存在左房血栓,是检测房颤患者是否存在左房血栓的一种无创性方法.
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