Table 3.
Diagnostic yield of cardiovascular MRI as compared to echocardiography for detection of prespecified cardioaortic sources of embolism in studies including patients with stroke.
| Setting | Pathology | N patients | N Studies | Total patients with pathology on echo | Yield Echocardiography (95% CI) | Total patients with pathology on CMR | Yield CMR (95% CI) | P for comparison of CMR and Echo-cardiography |
|---|---|---|---|---|---|---|---|---|
| Studies in stroke patients | Left atrial (appendage) thrombus | 197 | 3 | 4 | 2.0% (0.06–4.0%) | 1 | 0.5% (0–1.5%) | 0.8791 |
| - TEE Studies | 20 | 1 | 0 | 0% | 0 | 0% | ||
| - TTE Studies | 75 | 1 | 4 | 5.3% (0.2–10.4%) | 1 | 1.3% (0–3.9%) | ||
| - Studies combination | 102 | 1 | 0 | 0% | 0 | 0% | ||
| Left ventricular thrombus | 221 | 4 | 7 | 3.2% (0.9–5.5%) | 11 | 5.0% (2.1–7.8%) | 0.8460 | |
| - TEE Studies | 44 | 2 | 2 | 4.5% (0–10.7%) | 2 | 4.5% (0–10.7%) | ||
| - TTE Studies | 75 | 1 | 5 | 6.7% (1.0–12.3%) | 8 | 10.7% (3.7–17.7%) | ||
| - Studies using combination | 102 | 1 | 0 | 0% | 1 | 1.0% (0–2.9%) | ||
| Valvular vegetation | 289 | 4 | 6 | 2.1% (0.4–3.7%) | 6 | 2.1% (0.4–3.7%) | 1.0 | |
| - TEE Studies | 113 | 2 | 2 | 1.8% (0–4.2%) | 2 | 1.8% (0–4.2%) | ||
| - TTE Studies | 75 | 1 | 2 | 2.7% (0–6.3%) | 3 | 4.0% (0–8.4%) | ||
| - Studies using combination | 101 | 1 | 1 | 1.0% (0–2.9%) | 2 | 2.0% (0–4.7%) | ||
| Non-thrombotic masses, e.g., tumor | 197 | 3 | 0 | 0% | 1 | 0.5% (0–1.5%) | 0.9598 | |
| - TEE Studies | 20 | 1 | 0 | 0% | 0 | 0% | ||
| - TTE Studies | 75 | 1 | 0 | 0% | 1 | 1.3% (0–3.9%) | ||
| - Studies using combination | 102 | 1 | 0 | 0% | 0 | 0% | ||
| Complex aortic plaques | 295 | 5 | 55 | 18.6% (14.2–23.1%) | 48 | 16.3% (12.1–20%) | 0.5546 | |
| - TEE Studies | 118 | 3 | 50 | 42.4% (33.5–51.3%) | 42 | 35.6% (27.0–44.2%) | ||
| - TTE Studies | 75 | 1 | 2 | 2.7% (0–6.3%) | 0 | 0% | ||
| - Studies using combination | 102 | 1 | 3 | 2.9% (0–6.2%) | 6 | 5.9% (1.3–10.4%) | ||
| Persistent foramen ovale (all TEE) | 246 | 5 | 132 | 53.7% (47.4–59.9%) | 72 | 29.3% (23.6–35.0%) | <0.001 |
CMR, cardiovascular MRI; CI, confidence interval; P, P-value for comparison of the diagnostic yield by McNemar test. Bold represents overall findings (TEE and TTE results combined).