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Mitsuo Matsumoto
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P2.17 - Treatment of Early Stage/Localized Disease (ID 189)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.17-06 - Analysis of Left Atrial Blood Flow Using 4D Flow MRI in the Patient Who Suffered from Cerebral Infarction After Left Upper Lobectomy (Now Available) (ID 465)
10:15 - 18:15 | Presenting Author(s): Mitsuo Matsumoto
- Abstract
Background
Cerebral infarction is one of the complication after left upper lobectomy, and it may be caused by thrombus in left atrial. However, the mechanism of incidence of cerebral infarction has not been elucidated. In order to elucidate it, we performed the blood flow analysis of left atrium including the stump of the left upper pulmonary vein, by 4D flow MRI, which is recently very useful for blood flow analysis.
Method
We examine blood flow by 4D flow MRI in 3 patients with cerebral infarction after left upper lobectomy.
Result
Case1: A 76-year-old woman underwent left upper lobectomy for lung adenocarcinoma (cT1aN0M0 stageIA1). She had atrial fibrillation and took edoxaban, oral anticoagulant medicine. Three days after the surgery, she made cerebral infarction in MRI. By chest CT a thrombus was found near the left upper pulmonary vein stump. Case 2: A 42-year-old woman underwent left upper lobectomy due to lung cancer (cT1aN0M0 stageIA1). She had Cushing syndrome. One month after the surgery, she was diagnosed as cerebral infarction in MRI. There was no evidence of incidence of thrombus by chest CT. Case 3: A 77-year-old woman underwent left upper lobectomy for lung adenocarcinoma (cT3N0M0 stageIIB). Five months after the surgery, she was diagnosed as cerebral infarction in MRI. CT showed thrombus in the left atrial appendage. We performed blood flow analysis in left atrium for the three patients by 4D flow MRI. It showed a decrease in blood flow near the left superior pulmonary vein stump and left atrium around the stump in all patients.
Conclusion
We performed blood flow analysis of left atrium by 4D flow MRI, and it was able to visualize the blood flow after left upper lobectomy. The analysis showed the reduction of blood flow not only in the left superior pulmonary vein stump but also in the left atrium. These results suggest that blood flow stagnation may induce the thrombus formation in left atrium, and cause cerebral infarctions. In future, we will compare the blood flow before and after surgery and simulate the blood flow in left atrium. We hope to select patients at high risk for stroke before left upper lobectomy using flow analysis.
