The value of computed tomography angiography for evaluation of left atrial enlargement in patients with persistent atrial fibrillation

Fig. 1. The image post-processing workstation software automatically calculated LAV. LAV included LAA, but not PV, which was manually cut and removed at the opening, and the LA posterior view of before editing (a) and after editing (b); (c) for the determination of levels measured for LA parameters: at the opening of the right inferior PV, with the largest LAA; (d) For the determination of the measured vertebral body, the reference line was positioned to the vertebral body at the same level as (c) the LA parameter was measured and corresponded to the vertebral body in the sagittal plane; (e) the reference line was rotated and positioned at the center of the upper and lower ½ of the vertebral body; (f) the cross section corresponding to the red reference line (e) was selected as the measurement level for vertebral parameters

Fig. 2. Measurement of LA parameters. (a) Parallel to the sagittal plane of the human body, the largest LA anteroposterior diameter (LAD1) was measured along the endocardial border; (b) parallel to the coronal plane of the human body, the largest LA transverse diameter (LAD2) was measured along the endocardial border; (c) LAA* was measured along the endocardial border, excluding the pulmonary vein confluence. Measurement of vertebral parameters. (d) Parallel to the sagittal plane of the human body, the maximum anteroposterior diameter (VD1) of the vertebral body was measured along the endomembrane boundary; (e) parallel to the coronal plane of the human body, the maximum transverse diameter (VD2) of the vertebral body was measured along the endomembrane boundary; (f) the vertebral area (VA) was measured along the endomembrane boundary, excluding osteophytes

Fig. 3. (a), (b) Scatter plots of left atrial volume (LAV) and volume index (LAVI) at ES and MD phases, respectively, showed a positive linear relationship between LAVES and LAVMD, LAVIES and LAVIMD. (c), (d) Bland-Altman plots of intra observer agreement for LAVES or LAVMD measurements. Results 98% (49/50) of LAVES and 98% (49/50) of LAVMD measured values were distributed within the 95% limit of agreement, indicating that the measured values were in good agreement within the observer. (e), (f) Bland-Altman plots of agreement between observers for measuring LAVES and LAVMD. 96% (48/50) of LAVES and 96% (48/50) of LAVMD measurements were distributed within the 95% limits of agreement, and both LAVES and LAVMD measurements had good interobserver agreement

Fig. 4. (a) ROC curve of parameters measured during ES phase for LAE diagnosis, and each parameter was feasible. The diagnostic efficacy was as follows: LAA/ LAAI > LAD2 > LAVA > other LAD -related parameters. (b) ROC curve of parameters measured during MD phase for LAE diagnosis, and each parameter was feasible. The diagnostic efficacy was as follows: LAA/LAAI > LAVA/LAD2 > other LAD -related parameters