Pitfalls in establishing the diagnosis of deep venous thrombophlebitis by indium-111 platelet scintigraphy.
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.
Seabold
J E
JE
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Conrad
G R
GR
Kimball
D A
DA
Ponto
J A
JA
Bricker
J A
JA
D001792:Blood Platelets; D006801:Humans; D007205:Indium Radioisotopes; D010690:Phlebography; D011877:Radionuclide Imaging; D013924:Thrombophlebitis / Q000000981:diagnostic imaging*
D007205:Indium Radioisotopes