Lee V W, Allard J C, Berger P, Plehn J, Grindlinger G A, Getchell J, Dunlop R, Vendetti F
Section of Nuclear Medicine, Boston City Hospital, MA.
Radiology. 1988 Jun;167(3):737-41. doi: 10.1148/radiology.167.3.3363132.
The usefulness of gated blood pool (GBP) scintigraphy in evaluating cardiac contusion among trauma patients was examined. In ten of 62 patients who sustained blunt chest trauma, phase images of GBP studies demonstrated delayed onset of right ventricular (RV) contractions (RV tardokinesis). Clinical charts of these ten patients were reviewed to determine the significance of this finding. Only one had no supportive evidence of cardiac injury. Four patients were determined to have clinically significant cardiac contusion on the basis of the occurrence of arrhythmias of cardiac failure during their hospital course. These patients had ventricular histogram widths greater than 30 degrees of the entire cardiac cycle at half maximum height and had a bifid peak in their ventricular contraction histograms. Of the 52 patients who did not have RV tardokinesis, only one had a clinically significant cardiac contusion, resulting in a false-negative rate of 2% for the test. This new observation of RV tardokinesis may be clinically useful in establishing the difficult diagnosis of cardiac contusion.
研究了门控心血池（GBP）闪烁扫描术在评估创伤患者心脏挫伤中的作用。在62例钝性胸部创伤患者中，有10例GBP研究的相位图像显示右心室（RV）收缩延迟开始（RV运动迟缓）。回顾了这10例患者的临床图表，以确定这一发现的意义。只有1例没有心脏损伤的支持证据。4例患者根据住院期间出现的心律失常或心力衰竭被确定为有临床意义的心脏挫伤。这些患者的心室直方图宽度在整个心动周期半最大高度时大于30度，并且心室收缩直方图中有双峰。在52例没有RV运动迟缓的患者中，只有1例有临床意义的心脏挫伤，该检查的假阴性率为2%。RV运动迟缓这一新观察结果在确立困难的心脏挫伤诊断中可能具有临床用途。
