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Reliability of gated heart scintigrams for detection of left-ventricular aneurysm: concise communication
Insights
Gated heart scintigraphy accurately detects left-ventricular aneurysms, showing 96% overall accuracy. This reliable screening tool is recommended for suspected left-ventricular aneurysms, especially in apical and anterior locations.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Coronary artery disease frequently leads to left-ventricular aneurysms.
- Accurate detection of left-ventricular aneurysms is crucial for patient management and surgical planning.
Purpose of the Study:
- To evaluate the diagnostic accuracy of gated heart scintigraphy in detecting left-ventricular aneurysms.
- To compare scintigraphic findings with angiocardiography in patients with coronary artery disease.
Main Methods:
- Gated heart scintigrams and angiocardiograms were performed on 138 patients with coronary artery disease.
- Sensitivity, specificity, and overall accuracy were calculated for scintigraphy in aneurysm detection.
Main Results:
- Scintigraphy detected 61 of 64 left-ventricular aneurysms identified by angiography, achieving 96% overall accuracy.
- The technique demonstrated high reliability for apical and anteroapical aneurysms but lower accuracy for anterior and posterobasal locations.
- Two false positives and two false negatives were observed in the study population.
Conclusions:
- Gated heart scintigraphy is a highly reliable screening procedure for suspected left-ventricular aneurysms.
- Its accuracy is particularly notable in the apical and anterior regions, where most aneurysms are located.
- The findings support the use of scintigraphy as a valuable tool in the diagnostic pathway for left-ventricular aneurysms.
Abstract:
Gated heart scintigrams and angiocardiograms were performed on 138 patients with coronary artery disease. Scintigraphy detected 61 of 64 left-ventricular aneurysms demonstrated by angiography. The scintigram correctly identified all 54 apical and anteroapical aneurysms and one inferior aneurysm, but missed one of six anterior and two of three posterobasal aneurysms. In 74 patients with angiograms negative for aneurysm, the scintigram was also negative in 72, with two false positives. Overall accuracy of gated heart scintigraphy for the detection of aneurysm was 96% (133/138). Cardiac surgery was performed on 76 patients, and the angiographic findings were confirmed in all cases. Scintigraphic findings were confirmed in 74 of 76 patients. Among ten patients scintigraphed before and after aneurysmectomy, problems were first recognized by the scintigram in three cases. Gated heart scintigraphy is recommended as a screening procedure for suspected left-ventricular aneurysm because of its high reliability in the apical and anterior portions of the heart, where most of the aneurysms occur.