Reimers C, Van Tosh A, Berger M, Luna E, Horowitz S F
Department of Medicine, Beth Israel Medical Center, New York 10003.
Chest. 1993 Sep;104(3):946-7. doi: 10.1378/chest.104.3.946.
Radionuclide ventriculography is an accepted method for diagnosing left ventricular aneurysms, but false-negative studies have been associated with a mural thrombus filling the left ventricular cavity. We describe a patient with a left ventricular aneurysm due to myocardial infarction whose aneurysm scintigraphically "disappeared" from serial radionuclide ventriculograms. This was documented echocardiographically and pathologically to be due to the formation of a large mural thrombus. Review of the literature suggests that radionuclide ventriculography and echocardiography may be complementary techniques in the diagnosis of left ventricular aneurysm. Echocardiography may remain diagnostic when a mural thrombus has caused the loss of the characteristic scintigraphic findings on radionuclide ventriculography.
放射性核素心室造影术是诊断左心室室壁瘤的一种公认方法，但假阴性研究与填充左心室腔的壁内血栓有关。我们描述了一名因心肌梗死导致左心室室壁瘤的患者，其室壁瘤在系列放射性核素心室造影中闪烁显像“消失”。超声心动图和病理学证实这是由于形成了一个大的壁内血栓。文献回顾表明，放射性核素心室造影术和超声心动图在诊断左心室室壁瘤方面可能是互补技术。当壁内血栓导致放射性核素心室造影失去特征性闪烁显像表现时，超声心动图可能仍具有诊断价值。
