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111In-labeled platelet scintigraphy and two-dimensional echocardiography for detection of left atrial appendage thrombi: studies in a new canine model
Journal article   Open access   Peer reviewed

111In-labeled platelet scintigraphy and two-dimensional echocardiography for detection of left atrial appendage thrombi: studies in a new canine model

Byron F Vandenberg, James E Seabold, Gary R Conrad, Robert Kieso, Jann Johnson, Karen Fox-Eastham, James Ponto, Phillip Bruch and Richard E Kerber
Circulation (New York, N.Y.), Vol.78(4), pp.1040-1046
1988
DOI: 10.1161/01.CIR.78.4.1040
PMID: 3168184
url
https://doi.org/10.1161/01.CIR.78.4.1040View
Published (Version of record) Open Access

Abstract

111In-labeled platelet scintigraphy and two-dimensional echocardiography were performed in 40 dogs to determine the ability of the two techniques to detect left atrial appendage thrombi. Thrombi were induced in 33 dogs that were classified into two groups, "acute" or "chronic," according to the time of labeled-platelet injection after thrombus induction. In the acute group (17 dogs), platelets were injected 24 hours after thrombus induction. In the chronic group (16 dogs), platelets were injected 4-8 days after thrombus induction. "Sham" thoracotomies were performed on seven additional control dogs who did not receive thrombin injections. Analog and blood pool-corrected 111In-labeled platelet scintigraphy images were obtained 4-72 hours later. Closed-chest two-dimensional echocardiography was performed before thoracotomy and repeated at the time of scintigraphy. The location and size of each thrombus were verified at autopsy. Two-dimensional echocardiography detected three of 17 acute (mean volume, 1.2 +/- 1.0 cc) and three of 10 chronic (mean volume, 0.4 +/- 0.3 cc; p less than 0.025) left atrial appendage thrombi. 111In-labeled platelet scintigraphy detected all 17 acute thrombi but only two of 10 chronic thrombi. The measured radioactivity levels of the excised thrombi were 1,949 +/- 1,665 cpm/clot/dose in group 1 and 228 +/- 213 cpm/clot/dose in group 2 (p less than 0.005). In this model, 111In-labeled platelet scintigraphy was able to detect acute left atrial appendage thrombi that could not be identified by two-dimensional echocardiography. Both techniques showed poor sensitivity for detection of chronic thrombi. The decline in sensitivity of 111In-labeled platelet scintigraphy for detection of older thrombi is probably due to diminished labeled-platelet incorporation.
 Heart Cardiology. Vascular system Biological and medical sciences Endocardial and cardiac valvular diseases Medical sciences

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