Academic radiology · 2026
Dark-Blood Dual-Energy Cardiac CT for Evaluating Left Atrial Fibrosis, Atrial Fibrillation Type, and Post-Ablation Recurrence: A Retrospective Study Using Cardiac MR as Reference.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chong Huanhuan, Like Lahu, Xu Zhihan, Wu Peng, Li Jiqiang, Dong Haipeng, Yan Fuhua, Zhang Ning, Yang Wenjie
Аннотация
RATIONALE AND OBJECTIVES: To evaluate the feasibility of dual-energy cardiac computed tomography (DE-CCT) in detecting left atrial fibrosis (LAF), atrial fibrillation (AF) classifications, and postablation recurrence, using left atrial cardiac magnetic resonance (LA-CMR) as reference.
MATERIALS AND METHODS: This retrospective study included 81 pre-ablation AF patients without concomitant other arrhythmia or prior cardiac surgery. DE-CCT (utilizing dark-blood images with 5-minute post-injection iodine quantification) was quantitatively compared to concurrent LA-CMR to assess LAF, AF types, and recurrence risk.
RESULTS: For LAF detection, dark-blood images manifested high specificity (100%, 253/253 segments), moderate sensitivity (77.07%, 242/314 segments), and satisfactory accuracy (87.30%, 495/567 segments) compared with LA-CMR. Increased iodine ratio of LAF to blood pool (OR = 1.214, p = 0.041), incremental LAF segments in DE-CCT (OR = 1.739, p = 0.050), elevated brain natriuretic peptide (BNP), higher body mass index, and worse degree of left atrial volume index (LAVI) were significant risk indicators for PeAF (AUC=0.965, p<0.001). Concerning LA-CMR, independent risk factors for PeAF were also elevated LAF segments in CMR (OR = 2.108, p = 0.008), BNP levels, and LAVI grades (AUC=0.954, p<0.001). Cumulatively, 59 patients completed 1-year follow-up postablation, with 30.5% experiencing recrudescence. Significant predictors for 1-year relapse included increased LAF segments in DE-CCT (OR = 2.130, p = 0.009) or LA-CMR (OR = 1.740, p = 0.039), PeAF, thyrotoxicosis, and larger CHA2DS2-VASc scores, yielding AUCs of 0.895 (p<0.001) and 0.869 (p<0.001), respectively. No significant differences were found between DE-CCT and LA-CMR in discerning PeAF (p = 0.451) and early relapse (p = 0.114).
CONCLUSIONS: DE-CCT is a viable alternative for evaluating LAF, AF subtypes, and high-risk recurrence, comparable to LA-CMR, potentially enabling personalized therapy and guiding further studies on higher-resolution multi-energy CT.
MATERIALS AND METHODS: This retrospective study included 81 pre-ablation AF patients without concomitant other arrhythmia or prior cardiac surgery. DE-CCT (utilizing dark-blood images with 5-minute post-injection iodine quantification) was quantitatively compared to concurrent LA-CMR to assess LAF, AF types, and recurrence risk.
RESULTS: For LAF detection, dark-blood images manifested high specificity (100%, 253/253 segments), moderate sensitivity (77.07%, 242/314 segments), and satisfactory accuracy (87.30%, 495/567 segments) compared with LA-CMR. Increased iodine ratio of LAF to blood pool (OR = 1.214, p = 0.041), incremental LAF segments in DE-CCT (OR = 1.739, p = 0.050), elevated brain natriuretic peptide (BNP), higher body mass index, and worse degree of left atrial volume index (LAVI) were significant risk indicators for PeAF (AUC=0.965, p<0.001). Concerning LA-CMR, independent risk factors for PeAF were also elevated LAF segments in CMR (OR = 2.108, p = 0.008), BNP levels, and LAVI grades (AUC=0.954, p<0.001). Cumulatively, 59 patients completed 1-year follow-up postablation, with 30.5% experiencing recrudescence. Significant predictors for 1-year relapse included increased LAF segments in DE-CCT (OR = 2.130, p = 0.009) or LA-CMR (OR = 1.740, p = 0.039), PeAF, thyrotoxicosis, and larger CHA2DS2-VASc scores, yielding AUCs of 0.895 (p<0.001) and 0.869 (p<0.001), respectively. No significant differences were found between DE-CCT and LA-CMR in discerning PeAF (p = 0.451) and early relapse (p = 0.114).
CONCLUSIONS: DE-CCT is a viable alternative for evaluating LAF, AF subtypes, and high-risk recurrence, comparable to LA-CMR, potentially enabling personalized therapy and guiding further studies on higher-resolution multi-energy CT.
Предметные рубрики MeSH
HumansAtrial FibrillationFemaleMaleTomography, X-Ray ComputedRetrospective StudiesRecurrenceHeart AtriaSensitivity and SpecificityReproducibility of ResultsFibrosisMiddle AgedAgedCatheter AblationMagnetic Resonance ImagingRadiography, Dual-Energy Scanned ProjectionFeasibility StudiesTreatment Outcome