Subcutaneous radionuclide venography. An effective method for diagnosis of deep venous thrombosis

Traditional acupuncture points K-3 are physiologically tender points located halfway between the Achilles tendon and the medial malleolus. Recently, the authors developed a new method of radionuclide venography of the lower limbs, namely subcutaneous radionuclide venography (SC-RNV), by subcutaneous injection of Tc-99m pertechnetate at these points. The authors applied this method in a patient with suspected deep vein thrombosis of both lower limbs. For comparison, ascending radionuclide venography by intravenous injection (IV-RNV) of Tc-99m MAA and color Doppler ultrasound were also done. The SC-RNV showed partial obstruction of right popliteal vein and complete obstruction of the left popliteal vein with prominent collateral flows. These results were compatible with the findings of color Doppler ultrasound. However, the IV-RNV showed small narrowing with patency of the left popliteal vein, and normal flow on the right. This suggests that the results of SC-RNV may be different from that of IV-RNV. The benefits of SC-RNV in the detection of deep vein thrombosis are described.