title: Correlation of Tc-99m-red blood cell phleboscintigraphy with clinical severity of chronic venous disease.
abstract: Equilibrium red blood cell phleboscintigraphy of the lower limbs for the diagnostic management of chronic venous disease has been proposed. The aim of this study was to verify the correlation of the phleboscintigraphic assessment of chronic venous disease with the clinical grading of the severity of the disease, since other diagnostic modalities have been recently demonstrated a poor and only partial correlation. Equilibrium Tc-99m-red blood cell phleboscintigraphy was performed in 27 patients with chronic venous disease. Scintigraphic images of 52 limbs were classified according to a four-class qualitative grading of the severity of the venous disease, and a quantitative scintigraphic index (saphena /femoral ratio) was assigned to each limb. The scintigraphic qualitative grading showed a highly significant correlation with the clinical grading (Rs=0.82, p<0.01), a good interobserver and intraobserver agreement (86.5% and 92.3%, respectively) and more than 90% sensitivity and specificity to identify the categories "minimal or no chronic venous disease" or "more significant disease" (assessed according to the Bayes theorem). Sensitivity and specificity results for the quantitative assessment were not as good. Phleboscintigraphy correlates well with the clinical grading of the severity of chronic venous disease of the lower limbs and may have potential as a valuable diagnostic tool for the noninvasive assessment of chronic venous disease.
authors.affiliation: Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giordano
authors.forename: M L
authors.initials: ML
authors.lastname: Calcagni
authors.forename: F
authors.initials: F
authors.lastname: Rulli
authors.forename: M
authors.initials: M
authors.lastname: Muzi
authors.forename: G
authors.initials: G
authors.lastname: Martino
authors.forename: G
authors.initials: G
authors.lastname: D'Andrea
authors.forename: M
authors.initials: M
authors.lastname: Galli
authors.forename: E
authors.initials: E
authors.lastname: Zanella
mesh_terms: D002908:Chronic Disease; D004912:Erythrocytes / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D005121:Extremities / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013670:Sodium Pertechnetate Tc 99m; D017556:Technetium Compounds / Q000008:administration & dosage; D014652:Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D014680:Veins / Q000000981:diagnostic imaging*
chemical_list: D017556:Technetium Compounds; D013670:Sodium Pertechnetate Tc 99m