Journal of Ultrasound in Medicine, Vol 6, Issue 9 525-529, Copyright © 1987 by American Institute of Ultrasound in Medicine
Diagnostic accuracy of two-dimensional echocardiography for detection of left atrial thrombus in patients with mitral stenosis
C. W. Chiang, S. C. Pang, F. C. Lin, B. R. Fang, C. T. Kuo, Y. S. Lee and C. H. Chang
Cardiovascular Division, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Two-dimensional echocardiograms of 56 patients with mitral stenosis, who
subsequently underwent operation, were analyzed to evaluate the accuracy
for the detection of left atrial thrombi. From left parasternal, apical,
and subcostal cardiac windows, multiple planes (including standard planes
and their derived scanning planes) were assessed for the presence or
absence of mass echoes in the left atrium. The results showed 63%
sensitivity, 95% specificity, 87% positive predictive value, 84% negative
predictive value, and 83% overall diagnostic accuracy. Most of the
false-negative cases had their thrombi confined to the left atrial
appendage. We conclude that in patients with mitral stenosis,
two-dimensional echocardiography is promising for the diagnosis of left
atrial thrombi, particularly when they locate or extend to the main left
atrial cavity (not confined to atrial appendage).
