Mant M J, O'Brien B D, Russell D B
Arch Intern Med. 1981 Dec;141(13):1757-60. doi: 10.1001/archinte.141.13.1757.
Leg scanning with fibrinogen I 125, either alone on in combination with other procedures, has been proposed as an alternative to venography for diagnosis of deep venous thrombi. Clinical circumstances may necessitate anticoagulation before scanning can be performed, which could alter its reliability. We have compared the results of scanning with venographic findings in heparinized patients with venous thromboembolism. Different criteria for an abnormal leg scan gave different sensitivities and specificities. During the first four days of scanning with a requirement for a persistently abnormal result, five of eight criteria had high specificity (greater than 92%). However, sensitivities did not exceed 55%. With the use of transiently abnormal results and six days of scanning, higher sensitivities were obtained but specificities were reduced. No criterion gave results considered acceptable for a diagnostic test for deep venous thrombosis. Leg scanning should therefore not be used for this purpose in patients who have received anticoagulants. Our results also suggest that duration of symptoms has little effect on the sensitivity of leg scanning and that the test is more reliable for establishing the presence of thrombus than at defining its location.
使用碘125标记的纤维蛋白原进行腿部扫描，无论是单独使用还是与其他方法联合使用，都已被提议作为静脉造影术诊断深静脉血栓的替代方法。临床情况可能需要在进行扫描前进行抗凝治疗，这可能会改变其可靠性。我们比较了肝素化的静脉血栓栓塞患者腿部扫描结果与静脉造影结果。腿部扫描异常的不同标准给出了不同的敏感性和特异性。在扫描的前四天，要求结果持续异常，八项标准中有五项具有高特异性（大于92%）。然而，敏感性不超过55%。使用短暂异常结果并进行六天扫描，可获得更高的敏感性，但特异性降低。没有一项标准给出的结果被认为可接受用于深静脉血栓形成的诊断测试。因此，在接受抗凝剂治疗的患者中，腿部扫描不应为此目的使用。我们的结果还表明，症状持续时间对腿部扫描的敏感性影响很小，并且该测试在确定血栓存在方面比确定其位置更可靠。
