Indium-111 platelet scintigraphy for the diagnosis of acute venous thrombosis

Platelets labeled with indium-111 have been used successfully as a marker of active thrombosis in man. To establish the diagnostic accuracy of platelet scintigraphy in comparison to contrast venography in the diagnosis of acute lower limb venous thrombosis, we evaluated 103 consecutive patients divi...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1986-04, Vol.73 (4), p.668-674
Main Authors: EZEKOWITZ, M. D, POPE, C. F, ZARET, B. L, SOSTMAN, H. D, SMITH, E. O, GLICKMAN, M, RAPOPORT, S, SNIDERMAN, K. W, FRIEDLAENDER, G, PELKER, R. R, TAYLOR, F. B
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood and lymphatic vessels
Blood Platelets - diagnostic imaging
Cardiology. Vascular system
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Humans
Indium
Leg - blood supply
Male
Medical sciences
Middle Aged
Phlebography
Radioisotopes
Radionuclide Imaging
Thrombophlebitis - diagnostic imaging
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Summary:Platelets labeled with indium-111 have been used successfully as a marker of active thrombosis in man. To establish the diagnostic accuracy of platelet scintigraphy in comparison to contrast venography in the diagnosis of acute lower limb venous thrombosis, we evaluated 103 consecutive patients divided into two groups. Platelets were labeled by the indium-111 oxine method. Patients from group I (n = 73, 56 had venograms) were asymptomatic and underwent platelet scintigraphy 1.1 +/- 0.6 days (mean +/- 1 SD) after a major orthopedic procedure. Patients from group II (n = 30, all had venograms) were symptomatic and underwent platelet scintigraphy 1.2 +/- 1.7 days after venography. In group II, 15 patients with positive findings on contrast venography were treated with intravenous heparin; five others with positive venograms did not receive heparin until platelet scintigraphy was completed. Both platelet scintigraphy and contrast venography were evaluated by two blinded observers. Only studies with blinded agreement of both platelet scintigraphy and contrast venography were included in the analysis. Sensitivity and specificity of platelet scintigraphy for the whole limb were 93% and 97% in group I and 42% and 67% in group II. The lower sensitivity in group II was most likely attributable to therapy with heparin. These results demonstrate that platelet scintigraphy, a test that permits imaging for up to five days after a single injection, correlates favorably with contrast venography in patients who have not received heparin and may be used as a surveillance test in high-risk patients. The role of platelet scintigraphy in acutely symptomatic patients requires further evaluation.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.73.4.668