Radiology, Vol 146, 15-20, Copyright © 1983 by Radiological Society of North America
Plain radiographic diagnosis of thrombosis of left atrial appendage in mitral valve disease
S Matsuyama, T Watabe, S Kuribayashi, M Ootaki, Y Suzuki, M Sugihara, S Kawada, S Koide, A Shohtsu and H Tomoda
Conventional posteroanterior chest radiographs of 42 patients with mitral
valve disease who had had surgery were analyzed, and particular attention
was directed to the presence or absence of the convexity of the left lower
midcardiac border (left atrial segment). The flatness or concavity of this
segment, despite other evidence of left atrial enlargement, was observed in
six (60%) of 10 patients who had left atrial thrombosis, and in three (9%)
of 32 patients who did not have thrombosis (false positive diagnosis). Four
of the 10 patients who had left atrial thrombosis did not show this finding
on the radiographs (false negative diagnosis). One of these four had a
thrombus only against the posterior wall of the body of the left atrium.
Therefore, the accuracy in the diagnosis of thrombosis of the left atrial
appendage was 66.7% (six of nine) for patients who had thrombosis of the
appendage. Standard chest radiographs are important in the evaluation of
the patient with thrombosis of the left atrial appendage.
