Ikeoka K, Todo Y, Konishiike A, Fujisue R, Ohyanagi M, Yasutomi N, Tanimoto M, Kawai Y, Iwasaki T
J Cardiogr. 1985 Mar;15(1):67-78.
Intracardiac and arterial thrombi were examined by scintigraphy using In-111-oxine labeled autologous platelets. In 22 cases of myocardial infarction including six with ventricular aneurysms, four had positive findings of thrombi on imaging and detected also by echocardiography. All four had ventricular aneurysms. The so-called "moya-moya" echoes (fuzzy echoes) were demonstrated in two of these four cases. We encountered two cases with positive findings on imaging in 13 with mitral valve disease. These two had systemic embolic episodes after scintigraphic examination. "Moya-moya" echoes were detected in the left atrial cavity in four with negative findings on imaging. Positive images were obtained in two of three with acute arterial occlusive disease, and in both cases platelet deposition was observed in the proximal site of obstruction. Though thrombectomy was performed for one of these two cases, no thrombus was detected at the site of platelet deposition. After one month, re-examination revealed only negative findings in all sites in both these patients. In the six cases of aortic aneurysm, three had platelet deposition within their aneurysms, and surgery was performed for these positive cases, but one of them had no thrombus. Positive images were obtained in only one of seven patients with chronic arterial occlusive disease. Coagulation tests and platelet studies were investigated for patients with positive or negative platelet scans. Only the data of the thrombo-test showed a significant difference (97 +/- 9% vs 23 +/- 7%, p less than 0.001). Three cases of positive imaging became negative after anticoagulant therapy. We tried ECT for eight cases 24 hours after injection of In-111-oxine labeled platelets. Three cases showed clear images of thrombi, while the planar images could not detect them at an early stage. Therefore, we propose that ECT can be a useful technique for diagnosing intracardiac thrombi in early stage.
使用铟 - 111 - 奥克辛标记的自体血小板通过闪烁扫描术检查心内和动脉血栓。在22例心肌梗死患者中，包括6例患有室壁瘤的患者，4例在影像学上有血栓阳性发现且也被超声心动图检测到。这4例均患有室壁瘤。在这4例中的2例显示出所谓的“烟雾状”回声（模糊回声）。在13例二尖瓣疾病患者中，我们遇到2例在影像学上有阳性发现。这2例在闪烁扫描检查后发生了全身性栓塞事件。在影像学上为阴性的4例左心房腔内检测到“烟雾状”回声。3例急性动脉闭塞性疾病患者中有2例获得了阳性图像，并且在这2例中均在阻塞近端部位观察到血小板沉积。虽然对这2例中的1例进行了血栓切除术，但在血小板沉积部位未检测到血栓。1个月后，再次检查发现这2例患者所有部位均仅为阴性结果。在6例主动脉瘤患者中，3例在动脉瘤内有血小板沉积，对这些阳性病例进行了手术，但其中1例没有血栓。7例慢性动脉闭塞性疾病患者中只有1例获得了阳性图像。对血小板扫描阳性或阴性的患者进行了凝血试验和血小板研究。只有血栓试验的数据显示出显著差异（97±9%对23±7%，p＜0.001）。3例阳性影像学病例在抗凝治疗后变为阴性。在注射铟 - 111 - 奥克辛标记的血小板24小时后，我们对8例患者尝试了ECT。3例显示出清晰的血栓图像，而平面图像在早期无法检测到它们。因此，我们认为ECT可以成为早期诊断心内血栓的一种有用技术。
