Kosuda S, Kawakami R, Akita S, Mezaki T, Suzuki K, Kubo A, Hashimoto S
Department of Radiology, Tokyo Metropolitan Komagome Hospital.
Kaku Igaku. 1992 Apr;29(4):463-73.
We performed radioisotope (RI)-venography in 31 patients suspected of deep vein thrombosis (DVT), and 18 patients of them (58.1%) had abnormal findings. Out of the 18 patients, 14 satisfied the diagnostic criteria for DVT, that were interruption in the venous flow with the presence of collateral circulation. Sensitivity, specificity and accuracy of RI-venography for DVT were 100%, 76%, 87%, respectively. In all of the patients with chief complaints of edema and pain in the unilateral extremity DVT was found by RI-venography. Lung scan revealed multiple pulmonary perfusion defects in 4 (33.3%) of 12 patients with DVT. Out of the 4 patients, 3 (75%) had silent pulmonary thromboembolism. 99mTc-MAA accumulation was seen in the left lobe of the liver in a patient with occlusion of the IVC and common iliac veins. We are convinced that patients with PTE and/or edema and pain in the unilateral lower extremity should undergo routine RI-venography. In conclusion, RI-venography using 99mTc-MAA was reassessed and we obtained the result that it is useful for screening and monitoring DVT and pulmonary thromboembolism.
我们对31例疑似深静脉血栓形成(DVT)的患者进行了放射性核素(RI)静脉造影,其中18例(58.1%)有异常发现。在这18例患者中,14例符合DVT的诊断标准,即静脉血流中断并伴有侧支循环。RI静脉造影对DVT的敏感性、特异性和准确性分别为100%、76%、87%。在所有以单侧肢体水肿和疼痛为主诉的患者中,RI静脉造影均发现了DVT。肺部扫描显示,12例DVT患者中有4例(33.3%)存在多处肺灌注缺损。在这4例患者中,3例(75%)有无症状肺血栓栓塞。1例下腔静脉和髂总静脉闭塞的患者肝脏左叶可见99mTc-MAA聚集。我们确信,患有肺血栓栓塞症(PTE)和/或单侧下肢水肿及疼痛的患者应接受常规RI静脉造影。总之,对使用99mTc-MAA的RI静脉造影进行了重新评估,我们得到的结果是,它对DVT和肺血栓栓塞的筛查及监测有用。