Radiology, Vol 165, 355-360, Copyright © 1987 by Radiological Society of North America
Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy
JE Seabold, GR Conrad, JA Ponto, DA Kimball, EE Frey, F Ahmed, JD Coughlan and KC Jensen
Department of Radiology, University of Iowa Hospitals, Iowa City 52242.
Thirty-one nonheparinized patients with suspected deep venous
thrombophlebitis (DVT) underwent contrast venography and indium-111
platelet scintigraphy (In-111 PS). Venography permitted identification of
acute DVT in 12 of 31 cases (39%). One additional patient was considered to
have acute DVT despite nonconclusive venography results. In-111 PS results
were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of
13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS
studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in
patients not receiving anticoagulants was 82%. Venography results were
negative for acute DVT in 18 cases, and 4-hour In-111 PS studies were
negative or equivocal in each. In-111 PS is an alternative to contrast
venography for detecting acute DVT. If 4-hour In-111 PS results are
positive, anticoagulation can be initiated. Delayed images are necessary if
the 4-hour images are negative or equivocal.
