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[放射性核素静脉造影与X线静脉造影的比较]

[Comparison of radionuclide venography with roentgen phlebography].

作者信息

Fikrle A, Slípková D, Suchý M, Chudácek Z, Záhlava J, Cepelák V

出版信息

Cas Lek Cesk. 1989 Sep 15;128(38):1196-9.

PMID:2805036
Abstract

The authors evaluated a group of 78 patients where in addition to radionuclide venography (RNV) also X-ray phlebography was used (RTGF) within a time interval of not more than 72 hours. The results of 102 examinations were compared, 276 areas were correlated at six different sites. Agreement was recorded in 249 instances (90%), a false negative finding in 23 (8%) and a false positive finding in 4 (2%). Sensitivity was low in the area of the calf (55%), high in the femoral area, iliac area and in the area of the inferior vena cava (92-100%). The specificity was in all areas, incl. the calf, relatively high (94-100%). The investigation revealed the disadvantages of RNV--a low reliability in the area of the calf, the impossibility to detect small and parietal thrombi, the inability to assess the "activity and age" of the thrombus, the more difficult interpretation in insufficiency of venous perforators, and advantages of RNV--a great reliability at higher parts of the venous system and after administration of radiopharmaceutical preparations (RF) into peripheral veins, the possibility of simultaneous examination of pulmonary perfusion without further administration of RF, a low failure rate of intravenous administration of RF (less than 2%); RF do not irritate the venous endothelium and therefore thrombosis cannot develop; in case of paravenous escape of RF local inflammations do not develop, the radiation load is low, there is a small probability of allergic reactions, the method is non-invasive, it can be frequently repeated and used for the follow-up of treatment.

摘要

作者评估了一组78例患者,在不超过72小时的时间间隔内,除了放射性核素静脉造影(RNV)外,还使用了X线静脉造影(RTGF)。比较了102次检查的结果,在六个不同部位对276个区域进行了相关性分析。记录到249例(90%)结果一致,23例(8%)为假阴性结果,4例(2%)为假阳性结果。小腿部位的敏感性较低(55%),股部、髂部和下腔静脉部位的敏感性较高(92%-100%)。所有部位(包括小腿)的特异性相对较高(94%-100%)。该研究揭示了RNV的缺点——小腿部位可靠性低、无法检测小血栓和壁内血栓、无法评估血栓的“活性和年龄”、静脉穿通支功能不全时解读更困难,以及RNV的优点——在静脉系统较高部位以及将放射性药物制剂(RF)注入外周静脉后可靠性高、无需进一步注射RF即可同时检查肺灌注、RF静脉注射失败率低(低于2%);RF不会刺激静脉内皮,因此不会形成血栓;在RF静脉旁渗漏的情况下不会发生局部炎症、辐射负荷低、过敏反应概率小、该方法是非侵入性的、可频繁重复并用于治疗随访。

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