Objective To explore the value of Transesophageal echocardiography(TEE)and enhanced Computed Tomography(CT) in the detection of left atrial appendage thrombus in patients with atrial fibrillation before radiofrequency ablation.Methods 194 cases of atrial fibrillation admitted in our hospital were included,Transthoracic echocardiography(TTE) and TEE and enhanced CT were examined before surgery.The number of left atrial appendage thrombus were recorded respectively,and the results were compared with clinical diagnosis to evaluate the value of TEE and enhanced CT in the diagnosis of LAA thrombus.Results 3 patients in TTE,51 patients in TEE,and 17 patients in enhanced CT were found thrombus,And 33 patients with left atrial appendage thrombus were confirmed by clinical diagnosis.The diagnostic sensitivity of enhanced CT for the detection of thrombus in the left atrial appendage was 45 ％,the diagnostic specificity was 98 ％,and the positive predictive value was 88 ％.And the diagnostic sensitivity of TEE was 97％,the diagnostic specificity was 88％,the positive predictive value was 62 ％.Conclusions Enhanced CT have a higher diagnostic specificity of left atrial appendage thrombus in patients with atrial fibrillation,TEE combined with enhanced CT will do great importance before radiofrequency ablation.%目的 探讨经食管超声心动图与增强CT在心房颤动患者拟行射频消融术前左心耳血栓检测中的应用价值.方法 对194例拟行射频消融治疗的心房颤动患者,术前均行经胸、食管超声和增强CT检查,分别记录下检出血栓的例数,将血栓情况与临床诊断进行比较分析,评价经食管超声和增强CT在诊断LAA血栓方面的价值.结果 194例心房颤动患者经胸超声检出左心耳血栓3例;经食管超声检出左心耳血栓51例;增强CT检出左心耳血栓17例;经临床诊断证实存在左心耳血栓33例.增强CT对左心耳血栓检测的灵敏度45％、特异度98％、阳性预测值88％;经食管超声检测左心耳血栓的灵敏度97％、特异度88％、阳性预测值62％.结论 增强CT检测左心耳内血栓的特异度较高,经食管超声结合增强CT检查是心房颤动患者拟行射频消融术前左心耳血栓的有效检查手段.
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