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Dynamic radionuclide phlebography. A clinical study in patients after total hip replacement
European Journal of Nuclear Medicine
|July 1, 1978
Summary
Dynamic radionuclide phlebography effectively diagnoses iliofemoral thrombi after hip replacement. This nuclear medicine technique shows promise compared to traditional methods for detecting asymptomatic deep vein thrombosis.
Area of Science:
- Nuclear Medicine
- Vascular Imaging
- Radiology
Background:
- Deep vein thrombosis (DVT) is a complication after total hip replacement.
- Accurate diagnosis of iliofemoral thrombi is crucial for patient management.
- Conventional phlebography has limitations in assessing these thrombi.
Purpose of the Study:
- To evaluate the diagnostic accuracy of dynamic radionuclide phlebography (DRP) for iliofemoral thrombi post-total hip replacement.
- To compare DRP with contrast phlebography.
- To assess the utility of DRP in identifying asymptomatic thrombi.
Main Methods:
- Fifty consecutive patients undergoing total hip replacement were studied.
- A specialized injection technique for DRP was developed.
- Scintillation camera and digital computer recorded flow curves, mean transit time, and flow distribution.
Main Results:
- DRP identified significant flow distribution changes in 12 out of 15 legs with iliofemoral thrombi.
- Mean transit time helped differentiate superficial from deep venous flow.
- Lower leg DVT did not affect iliofemoral DRP findings; 90% of thrombi were asymptomatic.
Conclusions:
- Dynamic radionuclide phlebography is a valuable tool for diagnosing iliofemoral thrombi after total hip replacement.
- DRP demonstrates favorable comparison with 125I fibrinogen and impedance phlebography.
- The method effectively detects asymptomatic iliofemoral thrombi, offering a promising alternative diagnostic approach.