Reassessment of the Diagnostic Role of Technetium-99m-RBC Venography for Leg Venous Diseases

Lim, Yang Su; Kim, Sang Geol; Kim, Young Wook

Abstract

With the advent of duplex ultrasound imaging as a diagnostic tool of venous disease, radionuclide venography (RNV) is losing its popularity as a primary diagnostic method of venous disease. PURPOSE: We attempted to reassess the diagnostic role of RNV for the lower extremity venous disease as a primary and an adjuvant diagnostic method.
METHODS
Radionuclide venography (Technetium- 99m-RBC venography) and duplex scan (DS) were compared in 80 limbs of 80 patients having clinically suspcious deep venous disease of lower extremities. The criteria for positive RNV included 1) nonfilling of deep vein, 2) abnormal venous collaterals, 3) slow ascending of isotope, and 4) residual hot spot. Abnormal RNV findings were compared with DS findings in 3 groups of patients based on DS findings.
RESULTS
DS results can be divided as deep vein thrombosis (DVT) (n=46), chronic venous insufficiency (CVI) (n=18), and nonspecific (n=16). The concordance rates between RNV and DS were 79% in DVT group and 50% in CVI group. In 6 patients (7.5%) with negative or equivocal DS with positive RNV results, we could find clinically relevant findings of CVI on those limbs.
CONCLUSION
RNV seemed to have an acceptable role in the diagnosis of leg venous thrombosis as an adjuvant diagnostic method with DS, especially for the patients showing equivocal DS results.