Makino K, Yamamuro M, Ichikawa T, Futagami Y, Konishi T, Nakano T, Takezawa H
J Cardiogr. 1985 Sep;15(3):669-79.
For 52 patients with cardiac disease and 11 patients with vascular disease, In-111-oxine platelet scintigraphy was performed to assess its clinical usefulness for detecting thrombi. Using Hayashida's method, platelets were separated in 43 ml peripheral blood, washed and labeled with 1 mCi In-111-oxine. In addition to planar images in the anterior, 45 degrees left anterior oblique and left lateral views, single photon emission computed tomography (SPECT) was performed in some cases by rotating a dual gamma camera 24 and 72 hours after labeled platelet injection. The functions of platelet and coagulability were examined 36 hours after the injection of labeled platelets. Medical therapy was not changed during this study. Intracardiac thrombi were documented in 16 of 52 cases with cardiac disease and intravascular thrombi in 10 cases with vascular disease by angiography, CT and two-dimensional echocardiography. Positive images were obtained in 10 cases with cardiac disease and in eight cases with vascular disease by scintigraphy. Therefore, sensitivity, specificity, and overall accuracy were 63%, 100% and 88% in intracardiac thrombi; 80%, 100% and 82% in intravascular thrombi; and totally 69%, 100% and 87%, respectively. In the detection of intracardiac thrombi by scintigraphy, the sensitivity seemed to be lower and the specificity higher than those by other graphic studies. In 52 cases with cardiac disease, five out of six cases with false negative images had received antiplatelet and/or anticoagulant drugs, and in these cases, platelet and coagulation functions tended to be decreased compared with those of true positive cases or true negative cases. We conclude that positive images in scintigraphy indicate the existence of growing thrombi, and that In-111-oxine platelet scintigraphy has clinical usefulness, not only for detecting thrombi, but for estimating platelet activity and effect of medical therapy.
对52例心脏病患者和11例血管疾病患者进行了铟 - 111 - 奥克辛血小板闪烁扫描，以评估其在检测血栓方面的临床实用性。采用林田法，从43毫升外周血中分离血小板，洗涤后用1毫居里铟 - 111 - 奥克辛标记。除了在前位、左前斜45度和左侧位进行平面显像外，部分病例在注射标记血小板后24小时和72小时通过旋转双探头γ相机进行单光子发射计算机断层扫描（SPECT）。在注射标记血小板36小时后检测血小板功能和凝血能力。在本研究期间未改变药物治疗方案。通过血管造影、CT和二维超声心动图证实，52例心脏病患者中有16例存在心内血栓，11例血管疾病患者中有10例存在血管内血栓。闪烁扫描在10例心脏病患者和8例血管疾病患者中获得了阳性图像。因此，心内血栓的敏感性、特异性和总体准确率分别为63%、100%和88%；血管内血栓分别为80%、100%和82%；总体分别为69%、100%和87%。在通过闪烁扫描检测心内血栓时，其敏感性似乎低于其他影像学检查，而特异性则高于其他影像学检查。在52例心脏病患者中，6例假阴性图像的病例中有5例接受了抗血小板和/或抗凝药物治疗，与真阳性病例或真阴性病例相比，这些病例的血小板和凝血功能往往降低。我们得出结论，闪烁扫描中的阳性图像表明存在正在形成的血栓，铟 - 111 - 奥克辛血小板闪烁扫描不仅在检测血栓方面具有临床实用性，而且在评估血小板活性和药物治疗效果方面也具有临床实用性。
