Varicocelescintigraphy versus X-ray phlebography
In this study varicocelescintigraphy (VS) is compared to X-ray phlebography(XP). In 104 patients (pts) suspected for varicocele on physical examination, VS was performed using a large field camera and 5 mCi Tc-99m in-vivo labeled erythrocytes. This was done (without Valsalva) in upright position after taping penis to the abdomen, marking the penisbase and covering the thighs with lead. Twenty 5-sec dynamic images (DY) and 5-min static image (ST) were made. Variocele-size was quantitated by bloodpoolvalue (BPV) using digital image of ST. BPV is the ratio of mean counts/pixel in varicocele and right iliac vessels calculated from adjacent pixels with maximum counts. On XP varicocele was diagnosed if the testicular vein was visualized after contrast injection given during Valsalva in the renal vein. In 85 pts varicocele was confirmed on XP. In 67 of them this was recognized easily on both DY and ST; the DY shows activity in the varicocele 10-35 sec later than the iliac artery and the ST shows pooling of activity below the penisbase. In 11 pts the varicocele was only seen on ST and in other 5 pts only on DY. In the remaining 2 pts both DY and ST were false negative. The BPV in 72 pts with abnormal DY and in 11 pts with normal DY varied between 0.4 - 2.2(0.89 +- 0.38) resp. 0.4 - 1.0(0.61 +- 0.19). In 16 of the 19 pts who showed no varicocele on XP, VS also was negative; their BPV varied between 0.2 - 0.4(0.30 +- 0.08). However, in 3 pts who initially had a normal XP, varicocele was diagnosed on both DY and ST, which was confirmed when XP was repeated. Diagnosis of varicocele by physical examination is not accurate. VS is suitable for screenings procedure when both DY and ST are obtained. Pts with abnormal DY have larger varicocele than pts with normal DY.
- Research Organization:
- Univ. Hospital Utrecht
- OSTI ID:
- 6932538
- Report Number(s):
- CONF-840619-
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
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550601* - Medicine- Unsealed Radionuclides in Diagnostics
550602 - Medicine- External Radiation in Diagnostics- (1980-)