Stroke, Vol 18, 63-67, Copyright © 1987 by American Heart Association
C Kessler, H Henningsen, R Reuther, B Kimmig and M Rosch
Platelet scintigraphy (PSC) with indium-111 labelled platelets has been
confirmed as an adequate method for the detection of intracardiac thrombi
in patients with heart disease. We performed PSC of the heart and the neck
vessels in 27 stroke patients with suspected cardiac embolism and as
control on 10 patients with atherosclerotic lesions of the carotid arteries
without evidence of heart disease. The carotid PSC was positive in 6 of 10
patients with carotid disease, and twice in the 27 with suspected cardiac
embolism. In these 27 the PSC of the heart indicated pathological
conditions 13 times. Pathological platelet accumulations could be
visualized in 3 cases in the atrial space, in 9 cases in the region of the
left ventricle, and once at the aortic valve. Scintigraphy was negative in
all 10 patients with atherosclerosis of the neck vessels. The
two-dimensional echocardiography revealed pathological findings in 8 of the
13 patients with positive heart PSC (3 with intraventricular thrombi, 3
with valvular disease, 2 with decreased ventricular contractility) and was
normal in the 10 control patients. Open-heart surgery was performed in 2
patients with pathological PSC and revealed an intracardiac thrombus. Three
of 4 patients with positive atrial PSC showed mitral or aortic valve
disease. These results suggest that PSC can provide a valuable method for
detecting cardiac thrombi in stroke patients.
ARTICLES
Identification of intracardiac thrombi in stroke patients with indium- 111 platelet scintigraphy