Detection of postoperative deep-venous thrombosis using technetium-99m-labeled tissue plasminogen activator.
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.


METHODS
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.


RESULTS
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%.


CONCLUSIONS
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.
Butler
S P
SP
Department of Nuclear Medicine, St. George Hospital, Sydney, Australia.
Rahman
T
T
Boyd
S J
SJ
Parkes
S L
SL
Quinn
R J
RJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010690:Phlebography; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000209:etiology; D010959:Tissue Plasminogen Activator
D015609:Organotechnetium Compounds; C072781:technetium Tc 99m-tissue-type plasminogen activator; D010959:Tissue Plasminogen Activator