Assessment of Left Ventricular Thrombus Using Cardiac Computed Tomography

Left ventricular thrombus (LVT) can be missed on transthoracic echocardiogram and although cardiac magnetic resonance imaging (cMRI) is the gold standard of assessment, access to cMRI limited. Cardiac computed tomography (CCT) has been suggested as an alternative. This study prospectively investigated optimal CT acquisition time assess for presence LVT. Patients admitted Auckland City Hospital, New Zealand, found have LVT no contraindication CCT were recruited. The CCTs performed timed at peak contrast enhancement arterial-phase (CTA), 60–70 seconds delay venous-phase (CTV), multi-energy (CTD). was supported by Greenlane Cardiovascular Fund. Eleven patients recruited over a 30-month period. mean age 50±13 years 73% male. An confirmed in 10 (91%). One patient with TTE did not cMRI. Transthoracic echocardiography (TTE) failed detect 18% Amongst three protocols, best detected CTV when adjacent myocardium demonstrated good tissue differentiation, allowing improved detection. Although CTD able LVT, there reduction image quality. Resolution seen 78% 3 months all had resolved 6 months. radiation dose CTA 2.6±2.4 mSv, 1.5±0.9 mSv CTV, 3.6±1.8 CTD. There separation between thereby detection using (CTV).