DIAGNOSIS OF VENOUS THROMBOSIS - EVALUATI ON OF 99M TECHNETIUM-LABELED ANTIFIBRIN IMMUNOSCINTIGRAPHY

Objectives: We evaluated the interpretation, reliability and usefulnes s of 99m technetium labelled antifibrin immunoscintigraphy for the dia gnosis of deep vein thrombosis in the lower limbs. Methods: The diagno stic value of 99m technetium labelled antifibrin immunoscintigraphy wa s assessed in 44 patients with suspected venous thrombosis. The refere nce examination was bilateral ascending phlebography; 40 patients had doppler ultrasonography of the veins; 0.5 mg of antibody labelled by 1 7.5 mCi on average of 99m technetium were injected intravenously, and serial scintigraphic images were collected 1 min, 90 min and 18 hours after injection. Results: The best results were obtained by comparison between the 90 min and the immediate post-injection images, with 86 p ercent sensitivity, 73 percent specificity and 81 percent accuracy. He parin therapy and past history of phlebitis had no influence on the re sults, The doppler ultrasonography/immunoscintigraphy combination had a 100 percent specificity. 99m Technetium labelled antifibrin immunosc intigraphy had about the same diagnostic value as 111 indium labelled antifibrin immunoscintigraphy. Conclusion: The introduction of 99m tec hnetium as isotopic marker will make immunoscintigraphy easier and ava ilable in numerous nuclear medicine centres. Antifibrin immunoscintigr aphy can be an additional diagnostic tool for the difficult diagnosis of deep vein thrombosis.