Hopkins G B, Kan M K, Salel A F
JAMA. 1978 Nov 10;240(20):2162-5.
Thirty-five patients with coronary artery disease and possible left ventricular aneurysm underwent routine clinical examination, gated cardiac blood pool scintigraphy, and radionuclide cineangiography. Thirty-three of the 35 patients had coronary angiography and contrast left ventriculography. Sixteen patients had segmental left ventricular akinesia or dyskinesia, and 17 demonstrated left ventricular hypokinesis on contrast ventriculograms. Two patients had aneurysm confirmed at autopsy. Routine clinical evaluation was not sufficient to separate patients with aneurysm from those with hypokinesis. Radionuclide cineangiography correctly identified all cases of aneurysm or hypokinesis. The cinescintigraphic technique was preferable to the gated cardiac blood pool technique for qualitatively assessing and classifying abnormal ventricular wall motion. There was good correlation of the left ventricular ejection fraction by contrast ventriculograms and gated scintigrams in patients with either aneurysm or hypokinesis.
35例患有冠状动脉疾病且可能存在左心室室壁瘤的患者接受了常规临床检查、门控心血池闪烁扫描及放射性核素电影血管造影。35例患者中的33例进行了冠状动脉造影及对比剂左心室造影。16例患者出现节段性左心室运动不能或运动障碍,17例在对比剂心室造影中显示左心室运动减弱。2例患者尸检证实存在室壁瘤。常规临床评估不足以区分患有室壁瘤的患者和运动减弱的患者。放射性核素电影血管造影正确识别了所有室壁瘤或运动减弱病例。电影闪烁扫描技术在定性评估和分类异常心室壁运动方面优于门控心血池技术。在患有室壁瘤或运动减弱的患者中,对比剂心室造影和门控闪烁扫描测得的左心室射血分数具有良好的相关性。