Comparison of Indium-111 Platelet Scintigraphy and Two-Dimensional Echocardiography in the Diagnosis of Left Ventricular Thrombi

TLDR

The study compared indium‑111 platelet scintigraphy and two‑dimensional echocardiography for detecting left‑ventricular thrombi, validating findings against surgery or autopsy in 53 patients with aneurysms or mitral‑valve disease. Thrombi were confirmed in 14 of 34 aneurysm patients and in none of 19 mitral‑valve patients; echocardiograms were inadequate in 25 % of cases, but scintigraphy and echocardiography showed sensitivities of 71 % and 77 % and specificities of 100 % and 93 %, respectively, indicating that both modalities are useful and complementary for detecting and monitoring left‑ventricular thrombi. Published in N Engl J Med 1982; 306:1509–13.

Abstract

In a study comparing indium-111 platelet scintigraphy and two-dimensional echocardiography as methods of identifying left ventricular thrombi, the results obtained with both techniques were verified at surgery or autopsy in 53 patients — 34 with left ventricular aneurysms, and 19 with mitral-valve disease. Left ventricular thrombi were found at surgery or autopsy in 14 of the patients with aneurysms and in none of those with mitral-valve disease. Thirteen of 53 echocardiograms (25 per cent) were technically inadequate and excluded from the analysis. In the group with aneurysms, the sensitivity of scintigraphy in detecting thrombi was 71 per cent, and that of echocardiography was 77 per cent. The specificity of scintigraphy was 100 per cent, and that of echocardiography was 93 per cent. We conclude that indium-111 platelet scintigraphy and two-dimensional echocardiography have useful and complementary roles in the detection of left ventricular thrombi. Both these noninvasive techniques can be used to monitor therapy. (N Engl J Med. 1982; 306:1509–13.)