indium-oxine and Heart-Diseases

Topics: Aged; Aortic Aneurysm; Blood Platelets; Blood Vessel Prosthesis; Cell Survival; Cerebrovascular Disorders; Heart Diseases; Humans; Indium; Ischemic Attack, Transient; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radioisotopes; Radionuclide Imaging; Thrombocytopenia; Thromboembolism; Thrombophlebitis; Time Factors

Autologous 111In oxine-labelled platelet scintigraphy was used to detect left ventricular thrombi in 20 patients with anterior and 18 patients with inferior Q wave myocardial infarction within 48-72 h. Left ventricular thrombi were found in 8/20 patients with anterior myocardial infarction and in 1/18 patients with inferior myocardial infarction, giving a total incidence of 24%. Patients with left ventricular thrombi were older (64.3 versus 58.2 years), had higher peak creatinine kinase (CK) levels (4523 versus 2749 IU 1-1), lower ejection fraction (19.5 versus 37.8%, P less than 0.005) and were more likely to have an enlarged left ventricle than those without left ventricular thrombi (87.5 versus 54.5%, P less than 0.001). Left ventricular thrombi were found overlying sites of myocardial infarction in 8 out of 9 patients. Apical left ventricular thrombi were 1.7 times more common than septal left ventricular thrombi. All patients received minidose heparin for prevention of deep venous thrombosis. This technique is complementary to echocardiography and may provide additional information in the difficult cases where the decision about full-dose anticoagulation is in doubt.

Topics: Adult; Aged; Blood Platelets; Female; Heart Diseases; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis

The authors compare three diagnostic-imaging methods (two-dimensional-echography, heart scans and indium-111 platelet scintigraphy) used in the detection of intracardiac thrombi in 82 patients. They attempt to define their respective diagnostic values in the presence of left ventricular and atrial thrombi.

Topics: Blood Platelets; Contrast Media; Echocardiography; Female; Heart; Heart Diseases; Humans; Indium Radioisotopes; Ioxaglic Acid; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis

Topics: Adult; Aged; Aged, 80 and over; Aortic Aneurysm; Blood Platelets; Evaluation Studies as Topic; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombosis

A right atrial thrombus is not often seen and only a few reports of visualization have been described. We report a 44-yr-old man who had a large atrial thrombus associated with constrictive pericarditis. Two-dimensional echocardiography and computed tomography showed a large right atrial mass. Indium-111 oxine platelet deposition was demonstrated on the surface of thrombus by platelet imaging. Platelet imaging was useful for differential diagnosis from cardiac tumor, and as an indication for surgical treatment, since right atrial thrombus may have a high risk of pulmonary embolism or severe right heart failure.

Topics: Adult; Blood Platelets; Heart Diseases; Humans; Hydroxyquinolines; Indium Radioisotopes; Male; Organometallic Compounds; Oxyquinoline; Pericarditis, Constrictive; Radionuclide Imaging; Thrombosis

Topics: Adult; Blood Platelets; Evaluation Studies as Topic; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

Intracardiac and arterial thrombi were examined by scintigraphy using In-111-oxine labeled autologous platelets. In 22 cases of myocardial infarction including six with ventricular aneurysms, four had positive findings of thrombi on imaging and detected also by echocardiography. All four had ventricular aneurysms. The so-called "moya-moya" echoes (fuzzy echoes) were demonstrated in two of these four cases. We encountered two cases with positive findings on imaging in 13 with mitral valve disease. These two had systemic embolic episodes after scintigraphic examination. "Moya-moya" echoes were detected in the left atrial cavity in four with negative findings on imaging. Positive images were obtained in two of three with acute arterial occlusive disease, and in both cases platelet deposition was observed in the proximal site of obstruction. Though thrombectomy was performed for one of these two cases, no thrombus was detected at the site of platelet deposition. After one month, re-examination revealed only negative findings in all sites in both these patients. In the six cases of aortic aneurysm, three had platelet deposition within their aneurysms, and surgery was performed for these positive cases, but one of them had no thrombus. Positive images were obtained in only one of seven patients with chronic arterial occlusive disease. Coagulation tests and platelet studies were investigated for patients with positive or negative platelet scans. Only the data of the thrombo-test showed a significant difference (97 +/- 9% vs 23 +/- 7%, p less than 0.001). Three cases of positive imaging became negative after anticoagulant therapy. We tried ECT for eight cases 24 hours after injection of In-111-oxine labeled platelets. Three cases showed clear images of thrombi, while the planar images could not detect them at an early stage. Therefore, we propose that ECT can be a useful technique for diagnosing intracardiac thrombi in early stage.

Topics: Aged; Arterial Occlusive Diseases; Blood Platelets; Child; Child, Preschool; Heart Diseases; Humans; Hydroxyquinolines; Indium; Infant; Infant, Newborn; Male; Myocardial Infarction; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

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.

Topics: Blood Platelets; Female; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Thrombosis; Tomography, Emission-Computed

A scintigraphic technique using indium-111 labelled platelets to detect left atrial thrombi was used in 28 patients, 14 of whom had mitral valve disease and 14 combined valve disease. Imaging was performed in the anterior, right anterior oblique (45 degrees), and left lateral views on the day of injection and thereafter at one or two day intervals for a maximum of four days. When scintiphotos obtained in two or three views 72 or 96 hours after the platelet injection showed "hot spot areas" within the left atrial pool and indium-111 activity in these areas did not decrease with time they were interpreted as positive for thrombi. Of 28 patients, seven had positive platelet images by this criterion; of these, three underwent surgery and were found to have left atrial thrombi. One patient died, and a thrombus was found at necropsy. The remaining 21 patients had normal scintiphotos; of these, seven had no thrombi at operation and one had false negative images. The diagnostic accuracy of platelet scintigraphy by this criterion of positivity in the 12 patients in whom surgical or postmortem confirmation of thrombi could be obtained was 92%. These results indicate that this technique is a promising method for detecting active left atrial thrombi.

Topics: Adult; Aged; Blood Platelets; Female; Heart Atria; Heart Diseases; Heart Valve Diseases; Humans; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Radioisotopes; Radionuclide Imaging; Thrombosis

This study was designed to evaluate the efficacy of scintigraphy by using 111In-oxine labeled platelets for the detection of either intracardiac or intravascular thrombi. Fourteen cases of thrombi diagnosed or suspected on the basis of either angiography or two-dimensional echography were examined. They included four cases of left ventricular thrombi, three of left atrial thrombi, four of vascular thrombi and three of inflammatory disease. Platelet samples from the patients were labeled by 111In-oxine according to the method originated by Yui et al. The labeling efficiency was 72.4 +/- 9.8%. The platelets retained good function except for collagen aggregability. Hot areas of high quality in the scintigram were demonstrated in six cases including two with left ventricular thrombi, two with left atrial thrombi and two with vascular thrombi. These areas accorded well with the findings of angiography, echography or surgery. The removed thrombi had a layer of aggregated platelets on the surface. Platelet survival was shortened in a case of prosthetic valve endocarditis without a hot area, and was normal in four out of five cases including two with a hot area. It is concluded that this method is potentially predictive in detecting thrombi.

Topics: Adult; Aged; Aortic Aneurysm; Blood Platelets; Cardiomyopathy, Dilated; Female; Heart Atria; Heart Diseases; Humans; Hydroxyquinolines; Indium; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Pulmonary Embolism; Radionuclide Imaging; Takayasu Arteritis; Thrombosis