Abstract
In order to investigate the potential of computerised tomography in the detection of left ventricular mural thrombi, 16 patients suspected of having left ventricular mural thrombi were studied. All patients had suffered transmural myocardial infarction. Fifteen patients had a ventricle aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four of the eight patients. Both computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. Thus, computerised tomography appears to be a promising non-invasive technique and further studies of larger numbers of patients shown to have left ventricular thrombi at operation are indicated.