Skip to main content
SpringerLink
Log in

Detection of ventricular thrombosis in acute myocardial infarction: Value of indium-111 platelet scintigraphy in relation to two-dimensional echocardiography and clinical course

  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

In order to detect left ventricular (LV) thrombosis, 111In-platelet scintigraphy and two-dimensional echocardiography were performed in 40 patients 15 days±6 days after acute myocardial infarction. A dual isotope subtraction method, using 111In-platelet scintigraphy and 99mTc-blood pool scintigraphy, was used to assess LV platelet deposition expressed as LV counts per pixed. Seven patients (group A) had a positive 111In-platelet scintigram and 33 patients (group B) had a negative 111In-platelet scintigram (LV counts per pixel: 0.56±0.23 and 0.28±0.19, respectively, P<0.05). Three group A patients but no group B patients had a positive echocardiogram. Arterial embolism was noted in four patients, of whom two showed both positive echocardiogram and platelet scintigram. LV counts per pixel were 0.57±0.13 and 0.31±0.21, respectively (P<0.02) in patients with and without arterial embolism. Thus, both 111In-platelet scintigraphy and two-dimensional echocardiography can detect LV thrombosis. 111In-platelet scintigraphy may help to define patients at risk for embolization and may be used in conjunction with echocardiography to study the effect of antithrombotic therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Arvan S (1983) Left ventricular mural thrombi secondary to acute myocardial infarction: predisposing factors and embolic phenomenon. J Clin Ultrasound 11:467–473

    Google Scholar 

  • Asinger RW, Mikell FL, Elsperger J, Hodges M (1981a) Incidence of left ventricular thrombosis after acute myocardial infarction. Serial evaluation by two-dimensional echocardiography. N Engl J Med 305:297–302

    Google Scholar 

  • Asinger RW, Mikell FL, Sharma B, Hodges M (1981b) Observations on detecting left ventricular thrombus with two-dimensional echocardiography: emphasis on avoidance on false positive diagnoses. Am J Cardiol 47:145–156

    Google Scholar 

  • Bergmann SR, Lerch RA, Mathias CJ, Sobel BE, Welch MJ (1983) Noninvasive detection of coronary thrombi with In-111 platelets: consise communication. J Nucl Med 24:130–135

    Google Scholar 

  • Ezekowitz MD, Leonard JC, Smith EO, Allen EW, Taylor FB (1981) Identification of left ventricular thrombi in man using Indium-111 labeled autologous platelets. A preliminary report. Circulation 63:803–810

    Google Scholar 

  • Ezekowitz MD, Wilson DA, Smith EO, Burow RD, Harrison LH Jr, Parker DE, Elkins RC, Peyton M, Taylor FB (1982) Comparison of Indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi. N Engl J Med 306:1509–1513

    Google Scholar 

  • Ezekowitz MD, Burrow RD, Heath PW, Streitz T, Smith EO, Parker DE (1983) Diagnostic accuracy of Indium-111 platelet scintigraphy in identifying left ventricular thrombi. Am J Cardiol 51:1712–1716

    Google Scholar 

  • Ezekowitz MD, Kellerman FCCP, Smith EO, Streitz TM (1984) Detection of active left ventricular thrombosis during acute myocardial infarction using Indium-111 platelet scintigraphy. Chest 86:35–39

    Google Scholar 

  • Friedman MJ, Carlson K, Marcus FI, Woolfenden JM (1982) Clinical correlations in patients with acute myocardial infarction and left ventricular thrombus detected by two-dimensional echocardiography. Am J Med 72:894–898

    Google Scholar 

  • Frishman WH, Ribner HS (1979) Anticoagulation in myocardial infarction: modern approach to an old problem. Am J Cardiol 43:1207–1213

    Google Scholar 

  • Funke Küpper AJ, Verheugt FWA, Den Hollander W, Van der Wall EE, Roos JP (1984a) Identification of left ventricular thrombosis with Indium-111 platelet scintigraphy and two-dimensional echocardiography in recent myocardial infarction. Eur Heart J (Suppl I) 5:81

    Google Scholar 

  • Funke Küpper AJ, Verheugt FWA, Den Hollander W, Van der Wall EE, Roos JP (1984b) Quantitative Indium-111 platelet scintigraphy in detection of left ventricular thrombosis after acute myocardial infarction. Eur J Nucl Med (abstract) 9:26

    Google Scholar 

  • Gibson RS, Bishop HL, Stamm RB, Crampton RS, Beller GA, Martin RP (1982) Value of early two-dimensional echocardiography in patients with acute myocardial infarction. Am J Cardiol 49:1110–1119

    Google Scholar 

  • Keating EC, Gross SA, Schalmowitz RA, Glassman J, Mazur JH, Pitt WA, Miller D (1983) Mural thrombi in myocardial infarctions. Prospective evaluation by two-dimensional echocardiography. Am J Med 74:969–995

    Google Scholar 

  • Reeder GS, Tajik AJ, Seward JB (1981) Left ventricular mural thrombus. Two-dimensional echocardiography diagnosis. Mayo Clin Proc 56:82–86

    Google Scholar 

  • Stratton JR, Ritchie JL (1984) The effects of antithrombotic drugs in patients with left ventricular thrombi: assessment with Indium-111 platelet imaging and two-dimensional echocardiography. Circulation 69:561–568

    Google Scholar 

  • Stratton JR, Richie JL, Hamilton GW, Hammermeister KE, Harker LA (1981a) Left ventricular thrombi: in vivo detection by Indium-111 platelet imaging and two-dimensional echocardiography. Am J Cardiol 47:874–881

    Google Scholar 

  • Stratton JR, Ritchie JL, Hammermeister KE, Kennedy JW, Hamilton GW (1981b) Detection of left ventricular thrombi with radionuclide angiography. Am J Cardiol 48:565–572

    Google Scholar 

  • Thakur ML, Welch MJ, Joist JH, Coleman RE (1976) Indium-111 labeled platelets: studies on preparation and evaluation of in vitro and vivo functions. Thromb Res 9:345–357

    Google Scholar 

  • Thompson JE, Weston AS, Sigler L, Rant PS, Austin DJ, Patman RD (1970) Arterial embolectomy after acute myocardial infarction: a study of 31 patients. Ann Surg 171:979–986

    Google Scholar 

  • VA Cooperative Clinical Study Group (1973) Anticoagulants in acute myocardial infarction. JAMA 225:724–730

    Google Scholar 

  • Verheugt FWA, Lindenfeld J, Kirch DL, Steele PP (1983) Quantitative Indium-111 platelet scintigraphy in the diagnosis of LV thrombus: comparison with 2DE. Eur Heart J (Suppl E) 4:58

    Google Scholar 

  • Verheugt FWA, Lindenfeld J, Kirch DL, Steele PP (1984) Left ventricular platelet deposition after acute myocardial infarction: an attempt at quantification using blood pood subtracted Indium-111 platelet scintigraphy. Br Heart J 52:490–496

    Google Scholar 

  • Visser CA, Kan G, David GK, Lie KI, Durrer D (1983) Two dimensional echocardiography in the diagnosis of left ventricular thrombus. A prospective study of 67 patients with anatomic validation. Chest 83:228–232

    Google Scholar 

  • Visser CA, Kan G, Meltzer RS, Dunning AJ, Roelandt J (1985) Embolic potential of left ventricular thrombus after myocardial infarction: a two-dimensional echocardiographic study of 119 patients. JACC 5:1276–1280

    Google Scholar 

  • Weinreich DJ, Burke JF, Pauletto FJ (1984) Left ventricular mural thrombi complicating acute myocardial infarction, long-term follow-up with serial echocardiography. Ann Intern Med 100:789–794

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Free University Hospital, Amsterdam, The Netherlands

    Alber J. Funke Küpper, Freek W. AA. Verheugt, Wybren Jaarsma, Ernst E. van der Wall, Machiel J. van Eenige & Jan P. Roos

  2. Department of Nuclear Medicine, Free University Hospital, Amsterdam, The Netherlands

    Willem den Hollander

Authors
  1. Alber J. Funke Küpper
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Freek W. AA. Verheugt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wybren Jaarsma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ernst E. van der Wall
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Machiel J. van Eenige
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Willem den Hollander
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jan P. Roos
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Funke Küpper, A.J., Verheugt, F.W.A., Jaarsma, W. et al. Detection of ventricular thrombosis in acute myocardial infarction: Value of indium-111 platelet scintigraphy in relation to two-dimensional echocardiography and clinical course. Eur J Nucl Med 12, 337–341 (1986). https://doi.org/10.1007/BF00263815

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00263815

Key words

Search

Navigation