Nillius A, Willner S, Arborelius M, Nylander G
Clin Orthop Relat Res. 1980 Oct(152):241-6.
Iliac vein thrombosis is an uncommon type of deep vein thrombosis (DVT) that occurs in young patients following surgical procedures for scoliosis. The symptomatology is diffuse and this type of DVT carries a risk for fatal pulmonary embolism as well as the development of a postphlebitic syndrome. Combined radionuclide phlebography and lung scanning were performed in 16 patients operated on for scoliosis with the Harrington procedure. In three patients with diffuse pain in the inguinal region, iliac vein thrombosis was easily visualized in the radionuclide phlebogram and confirmed by conventional phlebography in two cases. Six patients without lung symptoms had perfusion defects typical for pulmonary embolism. It is concluded that radionuclide phlebography can be recommended as a diagnostic procedure for iliac vein thrombosis in patients with diffuse symptoms in the inguinal region or the lower abdomen after scoliosis surgery. Advantages include the ease of performance, good patient acceptance and low radiation dose compared with conventional phlebography. Asymptomatic pulmonary embolism as diagnosed by the perfusion lung scan was an unexpected finding which raised clinical considerations that require further investigations.
髂静脉血栓形成是一种罕见的深静脉血栓形成（DVT）类型，发生于接受脊柱侧弯手术的年轻患者。其症状较为弥散，这种类型的DVT存在致命性肺栓塞风险以及血栓形成后综合征的发生风险。对16例接受哈灵顿手术治疗脊柱侧弯的患者进行了放射性核素静脉造影和肺部扫描。在3例腹股沟区弥漫性疼痛的患者中，放射性核素静脉造影很容易显示出髂静脉血栓形成，其中2例经传统静脉造影证实。6例无肺部症状的患者有典型的肺栓塞灌注缺损。结论是，对于脊柱侧弯手术后腹股沟区或下腹部有弥散症状的患者，放射性核素静脉造影可作为诊断髂静脉血栓形成的一种检查方法。其优点包括操作简便、患者接受度好以及与传统静脉造影相比辐射剂量低。通过灌注肺部扫描诊断出的无症状肺栓塞是一个意外发现，引发了需要进一步研究的临床思考。
