title: Computed tomography for detecting left atrial thrombus: a meta-analysis.
abstract: BACKGROUND
  Thromboembolism, usually originating from the left atrium (LA) and left atrial appendage (LAA), is a major complication of atrial fibrillation and may result in transient ischemic attack and stroke. Computed tomography (CT) is a noninvasive test for detection of LA and LAA thrombus. We sought to conduct a meta-analysis to evaluate the accuracy of CT in detecting LA/LAA thrombus.
  
  
  METHODS
  The PubMed, Medline, ISI Web of Knowledge and Cochrane Library databases up to June 2012 were searched for studies comparing CT and transesophageal echocardiography as the reference standard in detecting LA/LAA thrombus. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver operating characteristic (SROC) curves.
  
  
  RESULTS
  A total of 9 studies with 1646 patients were included in this meta-analysis. The publication years spanned from 2007 to 2012. For CT diagnosis of LA/LAA thrombus, the mean sensitivity and specificity were 81% (95% CI: 70-90%) and 90% (95% CI: 88-91%), respectively. The SROC analysis showed an area under the curve of 0.93.
  
  
  CONCLUSIONS
  Computed tomography shows a good diagnostic accuracy in detecting LA/LAA thrombus with high sensitivity and specificity. Thus CT should be considered the foremost noninvasive alternative to transesophageal echocardiography for detecting LA/LAA thrombus. Randomized studies at the patient level are needed to address the potential use of CT in detecting LA/LAA thrombus.
authors: Department of Cardiovascular Medicine, Second Affiliated Hospital of Medical School, Xi'an Jiaotong University, Shaanxi, China.
authors: Xiaosan
authors: X
authors: Wu
authors: Congxia
authors: C
authors: Wang
authors: Chunyan
authors: C
authors: Zhang
authors: Yan
authors: Y
authors: Zhang
authors: Faming
authors: F
authors: Ding
authors: Jiaojuan
authors: J
authors: Yan
keywords: computed tomography; left atrial thrombus; meta-analysis; transesophageal echocardiography