目的 分析多层螺旋CT(MSCT)与 经食管超声心动图(TEE)两种影像学检查 方法对房颤患者左心耳血栓的诊断价值。 方法 遴选近一年(2017年1月-2018年1月) 来我院诊治的房颤患者195例，在拟行导 管消融治疗前均行冠状动脉CT血管造影 (CTA)及实时三维经食管超声心动图(RT3D-TEE)检查，以RT-3D-TEE检查结果为 “金标准”，分析评估CTA检查的诊断效 能，并比较两种检查结果的一致性。结 果 RT-3D TEE检查诊断左心耳血栓阳性 患者14例，左心耳血栓阴性患者181例， 以RT-3D TEE检查结果为参考标准，冠脉 CTA检查诊断房颤患者左心耳血栓的灵敏 度、特异度、准确度、阳性预测值、阴性 预测值分别为78.57%、96.69%、95.38%、 64.71%、98.31%；两种检查方法对房颤患 者左心耳血栓的诊断结果具有较高的一致 性(kappa值=68.79%，P<0.01)。结论 多 层螺旋CT技术对房颤患者左心耳血栓的诊 断效能较高，且与超声心动图检测结果一 致性佳。

Objective To analyze the diagnostic value of two imaging examinations of multi-slice spiral CT (MSCT) and transesophageal echocardiography (TEE) for left atrial appendage thrombosis in patients with atrial fibrillation. Methods 195 cases of patients with atrial fibrillation who were diagnosed and treated in our hospital during the past year (January 2017 to January 2018) were selected. evaluated by computed tomographic angiography (CTA) and real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) before catheter ablation treatment. The RT-3D-TEE test results were used as "gold standard", and the diagnostic efficacy of CTA was evaluated and compared, and the consistency of the two methods was analyzed. Results 14 cases of patients with positive left atrial appendage thrombus and 181 patients with negative left atrial appendage thrombus by RT-3D TEE examination. Taken RT-3D TEE test results as reference, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of coronary CTA examination in the diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation were 78.57%, 96.69%, 95.38%, 64.71% and 98.31% respectively. The two examination methods had high consistency in the diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation (kappa value=68.79%, P<0.01). Conclusion Multi-slice spiral CT has high diagnostic efficacy in the diagnosis of left atrial appendage thrombosis in patients with atrial fibrillation, and it has good consistency with the results of echocardiography.