Sakoda S, Kinoshita M, Suzuki T
First Department of Internal Medicine, Shiga University of Medical Science, Ohtsu.
J Cardiol. 1989 Mar;19(1):87-95.
The capability of diagnosing left ventricular thrombi was compared by scintigraphy using Ga-67-DFO-DAS-fibrinogen (Ga: gallium, DFO: deferoxamine, DAS: dialdehyde starch) and two-dimensional echocardiography. 1. Ga-67-DFO-DAS-fibrinogen scintigraphy and two-dimensional echocardiography were performed in 17 consecutive patients following myocardial infarction. In 11 of the 17 patients, left ventricular thrombi were visualized by Ga-67-DFO-DAS-fibrinogen scintigraphy, but only five of the 11 patients were found to have thrombi by two-dimensional echocardiography. 2. In eight patients with inferior or posterior myocardial infarction, no left ventricular thrombi were detected by two-dimensional echocardiography, while in six of the eight patients, ventricular thrombi were visualized by Ga-67-DFO-DAS-fibrinogen scintigraphy. 3. Among the patients receiving adequate anticoagulants from the episode, only three patients had thrombi. In contrast, the remaining eight patients with thrombi were either receiving no anticoagulants, or were receiving inadequate anticoagulant therapy. Ga-67-DFO-DAS-fibrinogen scintigraphy is a very simple and useful method for detecting thrombi in the left ventricle after myocardial infarction. It is more sensitive for detecting thrombi in the ventricle than was two-dimensional echocardiography. With this method, we can demonstrate the preventive effect of anticoagulants for left ventricular thrombus formation following myocardial infarction.
使用Ga-67-DFO-DAS-纤维蛋白原(Ga:镓,DFO:去铁胺,DAS:二醛淀粉)闪烁扫描法与二维超声心动图对诊断左心室血栓的能力进行了比较。1. 对17例连续发生心肌梗死后的患者进行了Ga-67-DFO-DAS-纤维蛋白原闪烁扫描法及二维超声心动图检查。在这17例患者中,11例通过Ga-67-DFO-DAS-纤维蛋白原闪烁扫描法显示有左心室血栓,但二维超声心动图仅在这11例患者中的5例发现有血栓。2. 在8例下壁或后壁心肌梗死患者中,二维超声心动图未检测到左心室血栓,而在这8例患者中的6例,Ga-67-DFO-DAS-纤维蛋白原闪烁扫描法显示有室壁血栓。3. 在发病后接受充分抗凝治疗的患者中,仅3例有血栓形成。相比之下,其余8例有血栓形成的患者要么未接受抗凝治疗,要么接受的抗凝治疗不充分。Ga-67-DFO-DAS-纤维蛋白原闪烁扫描法是检测心肌梗死后左心室血栓非常简单且有用的方法。它在检测心室血栓方面比二维超声心动图更敏感。通过这种方法,我们可以证明抗凝剂对心肌梗死后左心室血栓形成的预防作用。