Branchereau A, Bernard P J, Ciosi G, Bazan M, de Laforte C, Elias A, Bouvier J L
Service de Chirurgie Vasculaire, Hôpital de La Timone, Marseille, France.
Ann Vasc Surg. 1988 Jul;2(3):215-9. doi: 10.1016/S0890-5096(07)60003-X.
Forty-five patients (35 men, 10 women) undergoing carotid surgery had Indium-111 platelet scintigraphy as part of their preoperative work-up. Imaging was performed within three hours after injection of the Indium-111. A second series of views was obtained 24 hours later and repeated at 24 hour intervals for two days. Of 54 scintigrams, 22 were positive and 32 negative. Positive results were defined as a twofold or more increase in local activity on a visualized carotid after 24 hours. The sensitivity of the method was 41%, intraoperatively, and the specificity, 100%. The low sensitivity places this method behind sonography and duplex-scanning for screening patients for surgery. We believe that indications for platelet scintigraphy are limited to: 1. Repeated transient ischemic attacks in the same territory with minimal lesions on arteriography and non-homogeneous plaque on duplex scan; 2. Symptomatic patients being treated medically as a possible argument for surgery; 3. Determining therapeutic policy for patients having experienced a transient ischemic attack with a coexisting intracardiac thrombus.
45例接受颈动脉手术的患者（35例男性，10例女性）在术前检查中接受了铟-111血小板闪烁显像。在注射铟-111后3小时内进行显像。24小时后获取第二组图像，并以24小时间隔重复两天。在54份闪烁显像图中，22份为阳性，32份为阴性。阳性结果定义为24小时后可视化颈动脉局部活性增加两倍或更多。该方法术中的敏感性为41%，特异性为100%。低敏感性使该方法在筛选手术患者方面落后于超声检查和双功扫描。我们认为血小板闪烁显像的适应证仅限于：1. 同一区域反复出现短暂性脑缺血发作，动脉造影病变轻微且双功扫描斑块不均匀；2. 接受药物治疗的有症状患者，作为手术的可能依据；3. 确定伴有心内血栓的短暂性脑缺血发作患者的治疗策略。
