DETECTION OF POSTOPERATIVE DEEP-VENOUS THROMBOSIS USING TC-99M-LABELED TISSUE-PLASMINOGEN ACTIVATOR

The current noninvasive methods of deep-venous thrombosis (DVT) detect ion in the asymptomatic patient are sufficiently inaccurate so as to p reclude their routine use. This present study reports the accuracy of scintigraphic scanning with Tc-99m-rt-PA in asymptomatic postoperative patients using contrast venography as the gold standard. Methods: Fif ty-three consecutive postarthroplasty patients (30 THR, 23 TKR) (16 wo men, 37 men; mean age 71 yr; range 52-85 yr) underwent scintigraphic s canning with Tc-99m-rt-PA and contrast venography, on the operated leg , in order to assess the accuracy of this new technique in these asymp tomatic patients. Results: Eighty-four segments were of diagnostic qua lity on contrast venography. Of the 15 thrombosed segments, 14 had pos itive scans. In the 69 nonthrombosed segments, 63 had negative scans. Thus, scintigraphic scanning with Tc-99m-rt-PA had a sensitivity of 93 % and a specificity of 91%. Conclusion: This study demonstrated that s cintigraphic scanning with modified Tc-99m-rt-PA is accurate in the de tection of DVT in patients undergoing total hip or total knee arthropl asty.