111-Indium platelet imaging, Doppler spectral analysis and angiography compared in patients with transient cerebral ischaemia
An evaluation was made of carotid gamma imaging using /sup 111/Indium-labelled platelets in the diagnosis of carotid artery disease and measured the accumulation of labelled platelets was measured on endarterectomy specimens. Autologous /sup 111/In labelled platelets were injected in 25 patients with TIA. Gamma images were then taken daily and independently interpreted by two observers. Carotid endarterectomy was performed in 11 patients allowing measurement of the radioactivity on the operative specimen. These results were compared to the findings on angiography and Doppler spectral analysis. All endarterectomy specimens accumulated platelets with the most active equivalent to platelets from 1.8 ml blood. Atheromatous ulcers were more active than stenoses with mean (+/- SEM) activities of 1.12 +/- 0.37 and 0.38 +/- 0.10 respectively. These radioactivity levels were at the threshold of gamma camera resolution in a theoretical model. Both observers agreed that 22 of the 50 carotid bifurcations showed platelet accumulation on gamma imaging. Of the 12 atheromatous ulcers demonstrated by angiography 11 were visualized, but only five of ten stenoses greater than 80% were detected. As Doppler identified all stenoses only one angiographically diseased carotid was not detected by combining ultrasound with platelet scanning. Atherosclerotic arteries accumulate /sup 111/In platelets and the more thrombogenic ulcerated plaques are identified more frequently than stenoses. Long-term follow-up is required to establish the clinical relevance of platelet deposition.
- Research Organization:
- Queen Elizabeth Medical Centre, Birmingham, England
- OSTI ID:
- 6222641
- Journal Information:
- Stroke; (United States), Journal Name: Stroke; (United States) Vol. 14:5; ISSN SJCCA
- Country of Publication:
- United States
- Language:
- English
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