A comparative study of radionuclide venography and contrast venography in the diagnosis of deep venous thrombosis.
BACKGROUND
The value of the radionuclide blood pool venogram in detecting deep venous thrombosis (DVT) has to date been inadequately evaluated. This is despite its lower complication rate than the gold standard of contrast X-ray venography.


OBJECTIVE
To compare the relative accuracy and inter observer variability of radionuclide blood pool and X-ray contrast venography as well as evaluate previous literature on radionuclide venography.


METHODS
Prospective comparison of radionuclide and contrast venography was performed in 39 patients. Sensitivity and specificity of radionuclide venography were compared to contrast venography and confidence intervals were measured using standard error calculations. A meta-analysis of previous studies was also performed.


RESULTS
Significant inter observer variation in reports was present in both radionuclide (37%) and contrast (22%) venograms. Using consensus reports sensitivity of radionuclide venography was 87% compared to contrast venography and specificity was 83%. These results are similar to those obtained in previous studies. Furthermore, sensitivity in specificity in the proximal veins were 90% and 92% respectively which were superior to sensitivity and specificity in the distal veins where it was 74% and 90% respectively.


CONCLUSIONS
The radionuclide venogram appears accurate in the proximal veins and in excluding but not diagnosing distal venous thrombosis.
Kilpatrick
T K
TK
Department of Nuclear Medicine, Royal Melbourne Hospital, Parkville, Victoria.
Lichtenstein
M
M
Andrews
J
J
Gibson
R N
RN
Neerhut
P
P
Hopper
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010690:Phlebography; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013667:Technetium; D013924:Thrombophlebitis / Q000000981:diagnostic imaging*; D014680:Veins / Q000000981:diagnostic imaging
D003287:Contrast Media; D013667:Technetium