Pitfalls in establishing the diagnosis of deep venous thrombophlebitis by indium-111 platelet scintigraphy |
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Authors: | J E Seabold G R Conrad D A Kimball J A Ponto J A Bricker |
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Institution: | Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242. |
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Abstract: | Forty-seven 111In-platelet scintigraphs (In-PS) were analyzed retrospectively to identify sources of diagnostic error and to optimize the diagnostic criteria for active deep venous thrombophlebitis (DVT). The results of In-PS were compared with contrast venography, additional diagnostic studies, and clinical outcome. Three patterns of platelet localization emerged as the best predictors of active DVT: (a) focal or (b) linear 4-hr localization, or (c) an asymmetric blood-pool pattern on 4-hr imaging that evolved into a focal or linear pattern by 16 to 24 hr. All false-positive studies had abnormal patterns confined to the inguinal region at 24 hr. All patients with false-negative studies had received heparin between 4 and 24 hr. The potential pitfalls encountered in the evaluation of the iliac, femoral, and popliteal veins are reviewed and the importance of delayed imaging in selected cases is emphasized. |
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