平衡法核素显像诊断下肢深静脉血栓

DIAGNOSIS OF DEEP VEIN THROMBOSIS IN LOWER EXTREMITIES WITH EQUILIBRIUM RADIONUCLIDE IMAGING

目的：建立诊断下肢深静脉血栓的平衡期核素检查方法。方法：上肢静脉给药，体内法９９ｍＴｃ标记ＲＢＣ，３０分钟后先做平衡期静脉显像，然后用放射性核素体积描记术（ＲＰＧ）做血流测量。获得双下肢深静脉影像、ＲＰＧ曲线、深静脉回流血量和回流速度。结果：３５０例病人接受检查，其中回流正常者７８例，单侧梗阻１３３例，双侧病变１０８例，深静脉功能不全３１例。５０例病人同时做核素深静脉显像（ＲＮＶ），１０例同时做Ｘ线静脉造影，结果与核素平衡法的符合率均为９０％。结论：核素平衡法可用于临床常规检查，并可取代ＲＮＶ。

PURPOSE A procedure was developed for detecting deep vein thrombosis(DVT)in lower extremities.METHODS 30 min after i.v.of in vivo labelled 99mTc-RBC to the arm,equilibrium venography(EV)was performed.Radionuclide plethysmography (RPG) was continued and divided into two types:cuff above knees and above ankles. The following informations were provided by this technique:(1)equilibrium images of both legs,(2)segment of thrombosed vein (iliac,femoral,popliteal or tibial),(3)RPG curves,amount and speed of venous flow,(4)degree of venous occlusion (complete and incomplete obstruction).RESULTS Among 350 patients with suspected DVT,(1)78 cases were normal in venous flow,(2)133 cases had unilateral and 108 had bilateral obstruction,(3)31 cases suffered from venous insufficiency. Equilibrium method was compared with radionuclide venography(RNV)in 50 patients and compared with contrast venography(CV) in 10 patients.The coincidence rates were both 90%.CONCLUSION Instead of RNV,equilibrium method(EV+RPG)is recommended for routine examination of patients suspected DVT.