Diagnosis of left ventricular thrombi by magnetic resonance imaging and comparison with angiocardiography, computed tomography and echocardiography

Sechtem, Udo; Theissen, P.; Heindel, Walter; Hungerberg, Kerstin; Welslau, Ruth; Curtius, J. M.; Hügel, W; Höpp, H. W.; Schicha, H.

doi:10.1016/0002-9149(89)90878-3

Cited by 39 publications

(6 citation statements)

References 10 publications

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“…Differentiation between thrombus and slow-flowing blood on spin-echo MRI, however, may be difficult because of the increased MR signal produced by slow-flowing blood (Fig. 30) (Gomes et al 1987;Sechtem et al 1989). Brightblood MRI, in contrast, permits improved differentiation of thrombi from the surrounding blood pool and myocardium (Jungehulsing et al 1992).…”

Section: Thrombusmentioning

confidence: 99%

Cardiac Masses

Bogaert¹,

Dymarkowski²

2011

Clinical Cardiac MRI

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Section: Thrombusmentioning

confidence: 99%

Cardiac Masses

Bogaert¹,

Dymarkowski²

2011

Clinical Cardiac MRI

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“…Cardiac magnetic resonance has been shown to be substantially more sensitive than ECG at detecting previous silent MIs (32)(33)(34). CMR is also useful in assessing complications arising from acute MI including LV pseudoaneurysm (35), ventricular septal defect (36), mitral regurgitation (37), and ventricular thrombus (38,39).…”

Section: Structure and Tissue Characterizationmentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging for the Interventional Cardiologist

Figtree

Lønborg

Grieve

et al. 2011

JACC: Cardiovascular Interventions

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Cardiac magnetic resonance imaging is a noninvasive technique for assessing heart structure and function without the need for ionizing radiation. Its ability to precisely outline regions of myocardial ischemia and infarction gives it an important role in guiding interventional cardiologists in revascularization. Its ability to characterize and precisely quantify abnormal regurgitant flow volumes or abnormal shunts also makes it a valuable tool for many noncoronary interventions. This review will discuss the evidence for cardiac magnetic resonance in guiding complex therapies in the catheter laboratory, as well as practical issues that need to be addressed to allow the application of this powerful tool to an increasing number of our patients.

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“…However, this technique is cumbersome and expensive; it is not commonly used clinically. CT and magnetic resonance imaging have limited application for detection of LVT because of availability, convenience, cost, and motion artifact limiting their sensitivity to detect small LVT [29]. Surprisingly, contrast left ventriculography is relatively insensitive and nonspecific for detecting LVT and has some potential to mechanically dislodge thrombus [30].…”

Section: Detectionmentioning

confidence: 99%

Left ventricular thrombus

Stokman

Nandra

Asinger

2001

Curr Treat Options Cardio Med

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Left ventricular thrombus (LVT) is a frequent complication in patients with acute anterior myocardial infarction (MI) and in those with dilated cardiomyopathy (DCM). The clinical importance of LVT lies in its potential to embolize. The current treatment of patients with acute MI centers on reperfusion, and although controversial, the incidence of LVT complicating acute anterior MI is probably reduced when compared with historical controls. Nevertheless, stroke continues to be a clinically important complication of acute MI and is most common in patients with anterior MI, in part secondary to embolization of LVT. Therapeutic anticoagulation during acute MI reduces the incidence of LVT, and long-term anticoagulation has been associated with a reduction in recurrent infarction and ischemic stroke, but carries hemorrhagic risk. Primary treatment strategies for patients with acute MI center on reperfusion therapy followed by antiplatelet agents and pharmacologic blockade of abnormal neurohumoral mechanisms. Strategies to prevent stroke following infarction include risk stratification for development of LVT and embolism. For patients with anterior MI, particularly those with apical akinesis or dyskinesis, therapeutic anticoagulation reduces the number of LVT and cardioembolic strokes. However, the absolute number of ischemic strokes prevented with this strategy may only be marginal, given the anticoagulation risk, particularly if antiplatelet agents are used concurrently. An attractive alternative strategy is echocardiographic evaluation following anterior infarction with therapeutic anticoagulation reserved for those with demonstrable thrombus. The efficacy of this strategy, however, never has been proven in a clinical study. Primary prevention of cardioembolic stroke through therapeutic anticoagulation is controversial in patients with DCM; the greatest benefit would be expected for those with severe left ventricular dysfunction. If LVT is detected during the course of MI or DCM, therapeutic anticoagulation is usually indicated with the expectation that the majority of thrombi will resolve without clinical evidence of systemic embolism. Additional therapeutic intervention is rarely needed.

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Diagnosis of left ventricular thrombi by magnetic resonance imaging and comparison with angiocardiography, computed tomography and echocardiography

Cited by 39 publications

References 10 publications

Cardiac Masses

Cardiac Masses

Cardiac Magnetic Resonance Imaging for the Interventional Cardiologist

Left ventricular thrombus

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