Combined study of the strain gauge plethysmography and I-125 fibrinogen leg scan in the differentiation of deep vein thrombosis and postphlebitic syndrome
The fallibility of the clinical diagnosis of deep venous thrombosis (DVT) and postphlebitic syndrome has led to a variety of noninvasive diagnostic modalities, e.g, Doppler ultrasound, plethysmography, and radionuclide phlebography. The purpose of this study is to analyze the value of combined strain gauge plethysmography (SPG) and I-125 fibrinogen leg scanning in the differentiation of DVT and postphlebitic syndrome. Using strain gauge plethysmograph, 600 studies were performed on 502 patients. The maximum venous outflow (MVO) was calculated. An MVO of 20 cm3/100 cm3 of tissue/min or above was considered normal, and MVO of less than 20 cm3 was abnormal. Of those, 150 limbs had I-125 fibrinogen leg scan and venograms. Of 82 normal SPG, when compared with venograms, 75 were normal, five had postphlebitic syndrome, and two had DVT (97.6% true-negative). Sixty-eight legs had positive SPG, 46 of which had DVT (67.6% true-positive), 21 had postphlebitic syndrome (30.9%), and one was normal (1.5% false-positive). When rubber tourniquets were placed lightly on each leg between the strain gauge and the thigh cuff, 12 legs changed from positive SPG to negative SPG; 56 legs only had positive SPG. Forty-six of these had DVT (82.1% true-positive), nine had postphlebitic syndrome, and one was normal. When positive SPG was combined with positive leg scan, the accuracy raised to 95.6% (44 of 46 legs). If the SPG was positive but the leg scan was negative, the possibility of postphlebitic syndrome was most likely (8 of 10, i.e., 80%).
- OSTI ID:
- 5982249
- Journal Information:
- Am. Surg.; (United States), Vol. 50:11
- Country of Publication:
- United States
- Language:
- English
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LEGS
RADIOISOTOPE SCANNING
THROMBOSIS
DIAGNOSIS
FIBRINOGEN
IODINE 125
LABELLED COMPOUNDS
PATIENTS
TRACER TECHNIQUES
BETA DECAY RADIOISOTOPES
BLOOD COAGULATION FACTORS
BODY
BODY AREAS
CARDIOVASCULAR DISEASES
COAGULANTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GLOBULINS
HEMATOLOGIC AGENTS
HEMOSTATICS
INTERMEDIATE MASS NUCLEI
IODINE ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LIMBS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PROTEINS
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VASCULAR DISEASES
550601* - Medicine- Unsealed Radionuclides in Diagnostics