Stroke:心脏计算机断层扫描与经食管超声心动图检测左心耳血栓效果比较

2021-11-21 MedSci原创 MedSci原创

具有延迟成像的心脏计算机断层扫描是TEE可靠的替代方案。它可以使患者和医疗保健人员免于接受过多的TEE检查。

左心耳(LAA)血栓可能出现在导致左心房血流停滞的情况下,尤其是在心房颤动中,是心源性卒中的重要来源。根据2项大型前瞻性研究,经食道超声心动图(TEE)目前被认为是检测LAA血栓的金标准。然而,TEE是一种半侵入性且耗时的手术,并且TEE有时可能会引起不适并出现并发症。因此,心脏计算机断层扫描已被广泛用于LAA血栓的检测。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员进行了系统回顾和荟萃分析,以评估与TEE相比,心脏计算机断层扫描对LAA血栓检测的诊断准确性水平。

从1977年1月到2021年2月,研究人员对PubMed、Embase和Cochrane图书馆数据库进行了全面检索,纳入了与TEE相比,评估心脏计算机断层扫描对LAA血栓的诊断准确性的研究。研究人员使用双变量随机效应模型计算了LAA血栓的敏感性、特异性和后验概率。诊断准确性研究的质量评估-2工具用于质量评估。

该研究共纳入了27项研究,涉及了6960名患者。早期影像学研究的总体敏感性为0.95(95%CI为0.79-0.99),特异性为0.89(95%CI为0.85-0.92)。正后验概率为19.11%,负后验概率为0.16%。延迟成像研究的总体敏感性为0.98(95%CI为0.92-1.00),特异性为1.00(95%CI为0.98-1.00)。正后验概率为95.76%,负后验概率为0.12%。延迟成像方法显著提高了特异性(1.00 vs. 0.89;P<0.05)和阳性后验概率(95.76% vs. 19.11%;P<0.05)。

由此可见,具有延迟成像的心脏计算机断层扫描是TEE可靠的替代方案。它可以使患者和医疗保健人员免于接受过多的TEE检查。

原始出处:

Shandong Yu.et al.Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis.stroke.2021.https://www.ahajournals.org/doi/10.1161/JAHA.121.022505

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    2021-11-21 ms6000000656440728

    非常好的研究,患者往往因为不能耐受tee而不愿意检查

    1

    展开1条回复
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    2022-03-10 bioon14
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    2021-11-23 zhouqu_8
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1651079, encodeId=015c16510e9ed, content=<a href='/topic/show?id=2aa35090181' target=_blank style='color:#2F92EE;'>#心动图#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50901, encryptionId=2aa35090181, topicName=心动图)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a7624121693, createdName=zhu_jun9845, createdTime=Mon Oct 03 07:02:22 CST 2022, time=2022-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072531, encodeId=9e5c10e2531d6, content=非常好的研究,患者往往因为不能耐受tee而不愿意检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fd8b5623723, createdName=ms6000000656440728, createdTime=Sun Nov 21 16:09:14 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1201351, encodeId=f05512013511e, content=<a href='/topic/show?id=4f2092e900d' target=_blank style='color:#2F92EE;'>#超声心动图#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92790, encryptionId=4f2092e900d, topicName=超声心动图)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Thu Mar 10 14:50:48 CST 2022, time=2022-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1716425, encodeId=4ee01e16425ab, content=<a href='/topic/show?id=d68d911542f' target=_blank style='color:#2F92EE;'>#计算机#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91154, encryptionId=d68d911542f, topicName=计算机)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=def632217870, createdName=bioon14, createdTime=Thu Mar 10 06:02:22 CST 2022, time=2022-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437673, encodeId=34ee143e67372, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Nov 23 05:02:22 CST 2021, time=2021-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455639, encodeId=413114556392a, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Nov 23 05:02:22 CST 2021, time=2021-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072536, encodeId=61a310e2536b4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210826/7a6cce5e03844bcf8a6ee8a36dba8188/b15bf50504094d3aa56a8f1a32d3304c.jpg, createdBy=1d8c1533153, createdName=未来将来, createdTime=Sun Nov 21 16:33:39 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1072527, encodeId=c6fd10e2527fd, content=好极了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00ed5697300, createdName=ms6000001024089719, createdTime=Sun Nov 21 16:05:56 CST 2021, time=2021-11-21, status=1, ipAttribution=)]
    2021-11-21 未来将来

    学习了

    0

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    2021-11-21 ms6000001024089719

    好极了

    0

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