Detection of left ventricular thrombi by computerised tomography. A preliminary report.

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Abstract
To investigate the potential of computerized 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; 15 patients had a ventricular aneurysm, 1 had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 mo., with a range of 1-79 mo. All patients underwent computerized tomography of the heart, M-mode echocardiography (M-mode) and 2-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerized tomography, 2-D and M-mode echocardiography predicted left ventricular mural thrombi in 10, 8 and 1 of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in 4 of the 8 patients. Both computerized tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all 5 patients who underwent operation. In the same group, 2-D and M-mode echocardiography failed to predict the presence of thrombi in 1 and 3 patients, respectively. Among the 11 patients without surgical confirmation, 1, in whom no left ventricular thrombi were shown by M-mode and 2-D echocardiography, was found to have thrombi on computerized tomography. In another, 2-D echocardiography was positive but this finding was not confirmed either by computerized tomography or by left ventricular angiography. Computerized tomography appears to be a promising noninvasive technique.