Butler S P, Rahman T, Boyd S J, Parkes S L, Quinn R J
Department of Nuclear Medicine, St. George Hospital, Sydney, Australia.
J Nucl Med. 1997 Feb;38(2):219-23.
The current noninvasive methods of deep-venous thrombosis (DVT) detection in the asymptomatic patient are sufficiently inaccurate so as to preclude their routine use. This present study reports the accuracy of scintigraphic scanning with 99mTc-rt-PA in asymptomatic postoperative patients using contrast venography as the gold standard.
Fifty-three consecutive postarthroplasty patients (30 THR, 23 TKR) (16 women, 37 men; mean age 71 yr; range 52-85 yr) underwent scintigraphic scanning with 99mTc-rt-PA and contrast venography, on the operated leg, in order to assess the accuracy of this new technique in these asymptomatic patients.
Eighty-four segments were of diagnostic quality on contrast venography. Of the 15 thrombosed segments, 14 had positive scans. In the 69 nonthrombosed segments, 63 had negative scans. Thus, scintigraphic scanning with 99mTc-rt-PA had a sensitivity of 93% and a specificity of 91%.
This study demonstrated that scintigraphic scanning with modified 99mTc-rt-PA is accurate in the detection of DVT in patients undergoing total hip or total knee arthroplasty.
目前用于检测无症状患者深静脉血栓形成（DVT）的非侵入性方法准确性欠佳，无法常规使用。本研究报告了以99mTc-rt-PA进行闪烁扫描在无症状术后患者中的准确性，以静脉造影作为金标准。
连续纳入53例关节置换术后患者（30例全髋关节置换术，23例全膝关节置换术）（16例女性，37例男性；平均年龄71岁；范围52 - 85岁），对其手术侧下肢进行99mTc-rt-PA闪烁扫描及静脉造影，以评估该新技术在这些无症状患者中的准确性。
静脉造影有84个节段具有诊断质量。在15个血栓形成节段中，14个扫描呈阳性。在69个无血栓形成节段中，63个扫描呈阴性。因此，99mTc-rt-PA闪烁扫描的敏感性为93%，特异性为91%。
本研究表明，改良的99mTc-rt-PA闪烁扫描在检测全髋关节或全膝关节置换术患者的DVT方面具有准确性。
